How much rates vary
Facilitymedian $2,570 · 10th to 90th $759 to $5,888Professionalmedian $8,318 · 10th to 90th $4,365 to $10,965
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 $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $5,495.41 | Professional | None | $3,890.45 | $4,365.16 | $5,495.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,235.94 Typical High $4,073.80 | Professional | 54 · Surgery only | $2,951.21 | $3,235.94 | $4,073.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $436.52 Typical High $549.54 | Professional | 56 · Pre-op care only | $389.05 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,019.95 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,019.95 | $3,801.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $7,244.36 Median $9,332.54 Typical High $10,964.78 | Professional | None | $7,244.36 | $9,332.54 | $10,964.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $8,709.64 Median $11,220.18 Typical High $13,182.57 | Professional | 22 · Increased work | $8,709.64 | $11,220.18 | $13,182.57 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $5,011.87 Median $6,456.54 Typical High $7,762.47 | Professional | 54 · Surgery only | $5,011.87 | $6,456.54 | $7,762.47 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $724.44 Median $933.25 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $724.44 | $933.25 | $1,096.48 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,370.32 Median $6,918.31 Typical High $8,317.64 | Professional | 78 · Unplanned return to OR | $5,370.32 | $6,918.31 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $7,943.28 | Facility | None | $6,918.31 | $6,918.31 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $4,466.84 Median $7,762.47 Typical High $10,964.78 | Professional | None | $4,466.84 | $7,762.47 | $10,964.78 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $7,413.10 | Facility | None | $758.58 | $2,344.23 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $3,388.44 Median $7,762.47 Typical High $31,622.78 | Professional | None | $3,388.44 | $7,762.47 | $31,622.78 |
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 $3,311.31 Median $6,025.60 Typical High $9,120.11 | Professional | None | $3,311.31 | $6,025.60 | $9,120.11 |
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 $1,949.84 Median $2,137.96 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,949.84 | $2,137.96 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $870.96 Typical High $1,096.48 | Professional | 53 · Discontinued | $794.33 | $870.96 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $645.65 Typical High $812.83 | Professional | 55 · Aftercare only | $588.84 | $645.65 | $812.83 |
Where North Dakota sits
The same service costs 21.4 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
$8,128
AK $14,454TX $676
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.