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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,202.26 | Professional | None | $891.25 | $977.24 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $676.08 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $120.23 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $851.14 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,698.24 | $2,187.76 | $2,570.40 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,041.74 Median $2,630.27 Typical High $3,090.30 | Professional | 22 · Increased work | $2,041.74 | $2,630.27 | $3,090.30 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $218.78 Typical High $257.04 | Professional | 56 · Pre-op care only | $169.82 | $218.78 | $257.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,659.59 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,659.59 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,621.81 | $1,621.81 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,862.09 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $977.24 Typical High $2,398.83 | Facility | None | $758.58 | $977.24 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,778.28 Typical High $7,244.36 | Professional | None | $891.25 | $1,778.28 | $7,244.36 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,511.89 | Facility | None | $758.58 | $1,288.25 | $2,511.89 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,089.30 | Professional | None | $891.25 | $1,412.54 | $2,089.30 |
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 $446.68 Median $489.78 Typical High $602.56 | Professional | 52 · Reduced service | $446.68 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $239.88 | Professional | 53 · Discontinued | $177.83 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $181.97 |
Where North Dakota sits
The same service costs 24.5 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
$1,950
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.