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 $758.58 Median $758.58 Typical High $2,511.89 | Facility | None | $758.58 | $758.58 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $912.01 | Professional | None | $724.44 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $691.83 | Professional | 54 · Surgery only | $549.54 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $645.65 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,584.89 | $1,862.09 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,479.11 Median $1,905.46 Typical High $2,238.72 | Professional | 22 · Increased work | $1,479.11 | $1,905.46 | $2,238.72 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,096.48 Typical High $1,318.26 | Professional | 54 · Surgery only | $851.14 | $1,096.48 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $158.49 Typical High $186.21 | Professional | 56 · Pre-op care only | $123.03 | $158.49 | $186.21 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,174.90 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $912.01 | $1,174.90 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,513.56 | Facility | None | $1,318.26 | $1,318.26 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $2,041.74 | Professional | None | $794.33 | $1,445.44 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $2,137.96 | Facility | None | $758.58 | $1,023.29 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,348.96 Typical High $5,623.41 | Professional | None | $645.65 | $1,348.96 | $5,623.41 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,548.82 | Professional | None | $645.65 | $1,047.13 | $1,548.82 |
3 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 $363.08 Median $380.19 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $138.04 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $138.04 |
Where North Dakota sits
The same service costs 4.7 times more in Alaska than in Texas. 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· 8th of 51
$1,380
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.