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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,621.81 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,230.27 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,122.02 | $1,230.27 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $194.98 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,754.23 Median $3,548.13 Typical High $4,168.69 | Professional | None | $2,754.23 | $3,548.13 | $4,168.69 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $3,311.31 Median $4,265.80 Typical High $5,011.87 | Professional | 22 · Increased work | $3,311.31 | $4,265.80 | $5,011.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,511.89 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,949.84 | $2,511.89 | $2,951.21 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $354.81 Typical High $416.87 | Professional | 56 · Pre-op care only | $275.42 | $354.81 | $416.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,691.53 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,691.53 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,090.30 | Facility | None | $2,691.53 | $2,691.53 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,951.21 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,951.21 | $4,265.80 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,621.81 Typical High $2,754.23 | Facility | None | $758.58 | $1,621.81 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $12,022.64 | Professional | None | $1,318.26 | $2,754.23 | $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 $1,318.26 Median $2,238.72 Typical High $3,235.94 | Professional | None | $1,318.26 | $2,238.72 | $3,235.94 |
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 $741.31 Median $812.83 Typical High $977.24 | Professional | 52 · Reduced service | $741.31 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $389.05 | Professional | 53 · Discontinued | $295.12 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $295.12 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $295.12 |
Where North Dakota sits
The same service costs 20.4 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
$3,090
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.