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 $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $912.01 | Professional | None | $691.83 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $524.81 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $630.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,659.59 | $1,949.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,548.82 Median $1,995.26 Typical High $2,344.23 | Professional | 22 · Increased work | $1,548.82 | $1,995.26 | $2,344.23 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,174.90 Typical High $1,380.38 | Professional | 54 · Surgery only | $912.01 | $1,174.90 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $194.98 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $194.98 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,258.93 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $977.24 | $1,258.93 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,258.93 | $1,258.93 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,380.38 Typical High $1,949.84 | Professional | None | $812.83 | $1,380.38 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $5,495.41 | Facility | None | $741.31 | $3,235.94 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,288.25 Typical High $8,317.64 | Professional | None | $660.69 | $1,288.25 | $8,317.64 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $5,495.41 | Facility | None | $3,235.94 | $4,897.79 | $5,495.41 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,479.11 | Professional | None | $660.69 | $1,047.13 | $1,479.11 |
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 $346.74 Median $371.54 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $138.04 |
Where North Dakota sits
The same service costs 25.1 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
$1,445
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.