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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $295.12 | Professional | None | $213.80 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $177.83 Typical High $218.78 | Professional | 54 · Surgery only | $162.18 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $23.44 Typical High $29.51 | Professional | 56 · Pre-op care only | $21.38 | $23.44 | $29.51 |
BCBS North Dakota Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $588.84 | Professional | None | $380.19 | $501.19 | $588.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $457.09 Median $602.56 Typical High $707.95 | Professional | 22 · Increased work | $457.09 | $602.56 | $707.95 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $346.74 | $407.38 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.02 | $50.12 | $58.88 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $371.54 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $288.40 | $371.54 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Facility | None | $380.19 | $380.19 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $602.56 | Professional | None | $251.19 | $426.58 | $602.56 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $707.95 Typical High $2,344.23 | Facility | None | $234.42 | $707.95 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $4,365.16 | Professional | None | $218.78 | $407.38 | $4,365.16 |
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 $194.98 Median $331.13 Typical High $478.63 | Professional | None | $194.98 | $331.13 | $478.63 |
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 $107.15 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $107.15 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $47.86 Typical High $58.88 | Professional | 53 · Discontinued | $43.65 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $32.36 | $35.48 | $43.65 |
Where North Dakota sits
The same service costs 5.0 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· 10th of 51
$437
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.