How much rates vary
Facilitymedian $2,570 · 10th to 90th $759 to $3,981Professionalmedian $5,370 · 10th to 90th $2,630 to $7,244
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 $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,570.40 | $2,630.27 | $3,090.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,995.26 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,949.84 | $1,995.26 | $2,344.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $263.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $257.04 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,862.09 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,862.09 | $2,187.76 |
BCBS North Dakota Setting Professional Modifier None Typical Low $4,786.30 Median $6,165.95 Typical High $7,244.36 | Professional | None | $4,786.30 | $6,165.95 | $7,244.36 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $5,754.40 Median $7,413.10 Typical High $8,709.64 | Professional | 22 · Increased work | $5,754.40 | $7,413.10 | $8,709.64 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $4,265.80 Typical High $5,128.61 | Professional | 54 · Surgery only | $3,311.31 | $4,265.80 | $5,128.61 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $616.60 Typical High $724.44 | Professional | 56 · Pre-op care only | $478.63 | $616.60 | $724.44 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $4,570.88 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $3,548.13 | $4,570.88 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,370.32 | Facility | None | $4,677.35 | $4,677.35 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $5,248.07 Typical High $7,413.10 | Professional | None | $3,019.95 | $5,248.07 | $7,413.10 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $4,466.84 | Facility | None | $758.58 | $2,344.23 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $2,344.23 Median $4,677.35 Typical High $20,892.96 | Professional | None | $2,344.23 | $4,677.35 | $20,892.96 |
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 $2,344.23 Median $3,801.89 Typical High $5,370.32 | Professional | None | $2,344.23 | $3,801.89 | $5,370.32 |
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 $1,288.25 Median $1,318.26 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,288.25 | $1,318.26 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | 53 · Discontinued | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $398.11 Typical High $467.74 | Professional | 55 · Aftercare only | $389.05 | $398.11 | $467.74 |
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· 9th of 51
$5,370
AK $9,772TX $457
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.