How much rates vary
Facilitymedian $2,570 · 10th to 90th $759 to $6,026Professionalmedian $8,318 · 10th to 90th $4,365 to $11,220
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 $3,981.07 Median $4,365.16 Typical High $5,623.41 | Professional | None | $3,981.07 | $4,365.16 | $5,623.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,311.31 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,019.95 | $3,311.31 | $4,265.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $436.52 Typical High $562.34 | Professional | 56 · Pre-op care only | $398.11 | $436.52 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,090.30 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,090.30 | $3,981.07 |
BCBS North Dakota Setting Professional Modifier None Typical Low $7,413.10 Median $9,549.93 Typical High $11,220.18 | Professional | None | $7,413.10 | $9,549.93 | $11,220.18 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $8,912.51 Median $11,481.54 Typical High $13,489.63 | Professional | 22 · Increased work | $8,912.51 | $11,481.54 | $13,489.63 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $5,128.61 Median $6,606.93 Typical High $7,762.47 | Professional | 54 · Surgery only | $5,128.61 | $6,606.93 | $7,762.47 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $741.31 Median $954.99 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $741.31 | $954.99 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,495.41 Median $7,079.46 Typical High $8,317.64 | Professional | 78 · Unplanned return to OR | $5,495.41 | $7,079.46 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $8,128.31 | Facility | None | $7,079.46 | $7,079.46 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $4,570.88 Median $7,943.28 Typical High $10,964.78 | Professional | None | $4,570.88 | $7,943.28 | $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 $3,467.37 Median $7,762.47 Typical High $31,622.78 | Professional | None | $3,467.37 | $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 $6,165.95 Typical High $9,120.11 | Professional | None | $3,311.31 | $6,165.95 | $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 $1,995.26 Median $2,187.76 Typical High $2,818.38 | Professional | 52 · Reduced service | $1,995.26 | $2,187.76 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $870.96 Typical High $1,122.02 | Professional | 53 · Discontinued | $794.33 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $660.69 Typical High $851.14 | Professional | 55 · Aftercare only | $602.56 | $660.69 | $851.14 |
Where North Dakota sits
The same service costs 21.9 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
$8,318
AK $15,136TX $692
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.