How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $6,918.31 | Facility | None | $239.88 | $239.88 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $371.54 | Professional | None | $218.78 | $239.88 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $177.83 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $194.98 |
BCBS North Dakota Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $602.56 | Professional | None | $389.05 | $501.19 | $602.56 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $275.42 | $354.81 | $416.87 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $38.90 | $50.12 | $60.26 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $295.12 | $380.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $489.78 | Facility | None | $426.58 | $426.58 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $676.08 | Professional | None | $257.04 | $478.63 | $676.08 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $1,513.56 Typical High $2,754.23 | Facility | None | $239.88 | $1,513.56 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $416.87 Typical High $1,862.09 | Professional | None | $204.17 | $416.87 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $478.63 | Professional | None | $204.17 | $338.84 | $478.63 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | 52 · Reduced service | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $41.69 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $467.74 Median $602.56 Typical High $707.95 | Professional | 22 · Increased work | $467.74 | $602.56 | $707.95 |
Where North Dakota sits
The same service costs 6.0 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Dakota· 10th of 51
$447
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.