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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,318.26 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $173.78 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,230.27 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $3,715.35 | Professional | None | $2,454.71 | $3,162.28 | $3,715.35 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,951.21 Median $3,801.89 Typical High $4,466.84 | Professional | 22 · Increased work | $2,951.21 | $3,801.89 | $4,466.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,238.72 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,737.80 | $2,238.72 | $2,630.27 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $316.23 Typical High $371.54 | Professional | 56 · Pre-op care only | $245.47 | $316.23 | $371.54 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,398.83 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,398.83 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,691.53 | Facility | None | $2,344.23 | $2,344.23 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,691.53 Typical High $3,630.78 | Professional | None | $1,513.56 | $2,691.53 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $2,454.71 | Facility | None | $758.58 | $1,412.54 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,570.40 Typical High $10,471.29 | Professional | None | $1,148.15 | $2,570.40 | $10,471.29 |
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 $1,148.15 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,148.15 | $2,041.74 | $3,019.95 |
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 $645.65 Median $707.95 Typical High $870.96 | Professional | 52 · Reduced service | $645.65 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $346.74 | Professional | 53 · Discontinued | $257.04 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $263.03 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $263.03 |
Where North Dakota sits
The same service costs 5.0 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
$2,818
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.