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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $588.84 | Professional | None | $380.19 | $407.38 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $281.84 | $309.03 | $363.08 |
BCBS North Dakota Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $954.99 | Professional | None | $630.96 | $812.83 | $954.99 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $758.58 Median $977.24 Typical High $1,148.15 | Professional | 22 · Increased work | $758.58 | $977.24 | $1,148.15 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $446.68 | $575.44 | $676.08 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $616.60 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $478.63 | $616.60 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $776.25 | Facility | None | $676.08 | $676.08 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $1,071.52 | Professional | None | $416.87 | $758.58 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $1,995.26 Typical High $3,235.94 | Facility | None | $407.38 | $1,995.26 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $724.44 Typical High $3,311.31 | Professional | None | $346.74 | $724.44 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $831.76 | Professional | None | $338.84 | $549.54 | $831.76 |
4 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 $190.55 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $190.55 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $75.86 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.02 | $40.74 | $47.86 |
Where North Dakota sits
The same service costs 4.5 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· 11th of 51
$741
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.