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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,174.90 | Professional | None | $912.01 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $891.25 | Professional | 54 · Surgery only | $691.83 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $91.20 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $831.76 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $2,630.27 | Professional | None | $1,737.80 | $2,238.72 | $2,630.27 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,089.30 Median $2,691.53 Typical High $3,162.28 | Professional | 22 · Increased work | $2,089.30 | $2,691.53 | $3,162.28 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $223.87 Typical High $263.03 | Professional | 56 · Pre-op care only | $173.78 | $223.87 | $263.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,659.59 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,659.59 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,905.46 | Facility | None | $1,659.59 | $1,659.59 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,905.46 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,000.00 Typical High $2,398.83 | Facility | None | $758.58 | $1,000.00 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,659.59 Typical High $7,244.36 | Professional | None | $794.33 | $1,659.59 | $7,244.36 |
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 $812.83 Median $1,380.38 Typical High $1,949.84 | Professional | None | $812.83 | $1,380.38 | $1,949.84 |
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 $457.09 Median $501.19 Typical High $588.84 | Professional | 52 · Reduced service | $457.09 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $234.42 | Professional | 53 · Discontinued | $186.21 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $177.83 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $177.83 |
Where North Dakota sits
The same service costs 4.9 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
$1,950
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.