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 $549.54 Median $549.54 Typical High $2,511.89 | Facility | None | $549.54 | $549.54 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $602.56 | Professional | None | $524.81 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $426.58 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,288.25 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,202.26 Median $1,513.56 Typical High $1,819.70 | Professional | 22 · Increased work | $1,202.26 | $1,513.56 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $891.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $707.95 | $891.25 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $100.00 | $128.82 | $151.36 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $758.58 | $954.99 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Facility | None | $954.99 | $954.99 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,047.13 Typical High $1,513.56 | Professional | None | $575.44 | $1,047.13 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,584.89 Typical High $2,754.23 | Facility | None | $549.54 | $1,584.89 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $891.25 Typical High $4,168.69 | Professional | None | $457.09 | $891.25 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,047.13 | Professional | None | $457.09 | $741.31 | $1,047.13 |
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 $263.03 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $91.20 |
Where North Dakota sits
The same service costs 5.5 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· 8th of 51
$1,122
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.