How much rates vary
Facilitymedian $2,239 · 10th to 90th $759 to $3,162Professionalmedian $4,365 · 10th to 90th $2,239 to $5,888
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 $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,454.71 | Professional | None | $2,089.30 | $2,238.72 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,659.59 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,548.82 | $1,659.59 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $223.87 Typical High $245.47 | Professional | 56 · Pre-op care only | $208.93 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,548.82 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,548.82 | $1,737.80 |
BCBS North Dakota Setting Professional Modifier None Typical Low $3,801.89 Median $4,897.79 Typical High $5,888.44 | Professional | None | $3,801.89 | $4,897.79 | $5,888.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $4,570.88 Median $5,888.44 Typical High $6,918.31 | Professional | 22 · Increased work | $4,570.88 | $5,888.44 | $6,918.31 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $3,467.37 Typical High $4,073.80 | Professional | 54 · Surgery only | $2,691.53 | $3,467.37 | $4,073.80 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $489.78 Typical High $588.84 | Professional | 56 · Pre-op care only | $380.19 | $489.78 | $588.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,715.35 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,715.35 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,265.80 | Facility | None | $3,715.35 | $3,715.35 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $4,168.69 Typical High $5,888.44 | Professional | None | $2,344.23 | $4,168.69 | $5,888.44 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $3,801.89 | Facility | None | $758.58 | $2,238.72 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $3,630.78 Typical High $16,595.87 | Professional | None | $1,819.70 | $3,630.78 | $16,595.87 |
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 $1,819.70 Median $3,019.95 Typical High $4,265.80 | Professional | None | $1,819.70 | $3,019.95 | $4,265.80 |
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 $1,023.29 Median $1,122.02 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,023.29 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $446.68 Typical High $489.78 | Professional | 53 · Discontinued | $416.87 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $331.13 Typical High $371.54 | Professional | 55 · Aftercare only | $309.03 | $331.13 | $371.54 |
Where North Dakota sits
The same service costs 20.9 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
$4,169
AK $7,586TX $363
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.