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 $407.38 Median $407.38 Typical High $1,995.26 | Facility | None | $407.38 | $407.38 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $467.74 | Professional | None | $389.05 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $346.74 | Professional | 54 · Surgery only | $295.12 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $323.59 |
BCBS North Dakota Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $977.24 | Professional | None | $645.65 | $831.76 | $977.24 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $776.25 Median $1,000.00 Typical High $1,174.90 | Professional | 22 · Increased work | $776.25 | $1,000.00 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $575.44 Typical High $691.83 | Professional | 54 · Surgery only | $446.68 | $575.44 | $691.83 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $97.72 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $616.60 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $478.63 | $616.60 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $812.83 | Facility | None | $707.95 | $707.95 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $1,122.02 | Professional | None | $426.58 | $794.33 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $269.15 Typical High $707.95 | Facility | None | $125.89 | $269.15 | $707.95 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $707.95 Typical High $3,090.30 | Professional | None | $346.74 | $707.95 | $3,090.30 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $812.83 | Professional | None | $346.74 | $549.54 | $812.83 |
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 $194.98 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $194.98 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $69.18 |
Where North Dakota sits
The same service costs 4.2 times more in Wyoming 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
$724
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.