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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,288.25 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,884.03 | $3,388.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,691.53 Median $3,467.37 Typical High $4,073.80 | Professional | 22 · Increased work | $2,691.53 | $3,467.37 | $4,073.80 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,041.74 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,584.89 | $2,041.74 | $2,398.83 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $288.40 Typical High $338.84 | Professional | 56 · Pre-op care only | $223.87 | $288.40 | $338.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,187.76 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,187.76 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,454.71 | Facility | None | $2,089.30 | $2,089.30 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,348.96 | $2,454.71 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,398.83 | Facility | None | $758.58 | $1,288.25 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,549.93 | Professional | None | $1,047.13 | $2,344.23 | $9,549.93 |
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 $1,047.13 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,047.13 | $1,819.70 | $2,691.53 |
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 $588.84 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $588.84 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $229.09 |
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
$2,570
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.