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 $363.08 Median $363.08 Typical High $2,511.89 | Facility | None | $363.08 | $363.08 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $426.58 | Professional | None | $331.13 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $269.15 | $316.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $831.76 | Professional | None | $549.54 | $707.95 | $831.76 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $660.69 Median $851.14 Typical High $1,000.00 | Professional | 22 · Increased work | $660.69 | $851.14 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $380.19 | $501.19 | $588.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $407.38 | $537.03 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $676.08 | Facility | None | $588.84 | $588.84 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $933.25 | Professional | None | $371.54 | $660.69 | $933.25 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $1,513.56 Typical High $2,754.23 | Facility | None | $363.08 | $1,513.56 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $630.96 Typical High $2,818.38 | Professional | None | $302.00 | $630.96 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $724.44 | Professional | None | $302.00 | $478.63 | $724.44 |
4 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 $165.96 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $63.10 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $42.66 |
Where North Dakota sits
The same service costs 4.8 times more in Alaska 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· 13th of 51
$646
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.