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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,380.38 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $169.82 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $1,174.90 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $3,548.13 | Professional | None | $2,344.23 | $3,019.95 | $3,548.13 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,818.38 Median $3,630.78 Typical High $4,265.80 | Professional | 22 · Increased work | $2,818.38 | $3,630.78 | $4,265.80 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,089.30 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,621.81 | $2,089.30 | $2,454.71 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $302.00 Typical High $354.81 | Professional | 56 · Pre-op care only | $234.42 | $302.00 | $354.81 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,238.72 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,238.72 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,630.27 | Facility | None | $2,290.87 | $2,290.87 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,479.11 | $2,511.89 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,398.83 | Facility | None | $758.58 | $1,380.38 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,344.23 Typical High $12,022.64 | Professional | None | $1,122.02 | $2,344.23 | $12,022.64 |
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 $1,122.02 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,905.46 | $2,754.23 |
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 $630.96 Median $691.83 Typical High $851.14 | Professional | 52 · Reduced service | $630.96 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $338.84 | Professional | 53 · Discontinued | $251.19 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $208.93 | $251.19 |
Where North Dakota sits
The same service costs 5.2 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
$2,630
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.