How much rates vary
Facilitymedian $2,570 · 10th to 90th $759 to $5,248Professionalmedian $7,244 · 10th to 90th $3,802 to $9,772
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 $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,801.89 Typical High $4,168.69 | Professional | None | $3,467.37 | $3,801.89 | $4,168.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,884.03 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,630.27 | $2,884.03 | $3,162.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $380.19 Typical High $416.87 | Professional | 56 · Pre-op care only | $346.74 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,691.53 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,691.53 | $2,951.21 |
BCBS North Dakota Setting Professional Modifier None Typical Low $6,456.54 Median $8,317.64 Typical High $9,772.37 | Professional | None | $6,456.54 | $8,317.64 | $9,772.37 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $7,585.78 Median $10,000.00 Typical High $11,748.98 | Professional | 22 · Increased work | $7,585.78 | $10,000.00 | $11,748.98 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $4,466.84 Median $5,754.40 Typical High $6,760.83 | Professional | 54 · Surgery only | $4,466.84 | $5,754.40 | $6,760.83 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $645.65 Median $831.76 Typical High $977.24 | Professional | 56 · Pre-op care only | $645.65 | $831.76 | $977.24 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,786.30 Median $6,165.95 Typical High $7,244.36 | Professional | 78 · Unplanned return to OR | $4,786.30 | $6,165.95 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $7,244.36 | Facility | None | $6,309.57 | $6,309.57 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $6,918.31 Typical High $9,772.37 | Professional | None | $4,073.80 | $6,918.31 | $9,772.37 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $6,456.54 | Facility | None | $758.58 | $2,344.23 | $6,456.54 |
Medica Setting Professional Modifier None Typical Low $3,090.30 Median $6,309.57 Typical High $28,840.32 | Professional | None | $3,090.30 | $6,309.57 | $28,840.32 |
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 $3,090.30 Median $5,011.87 Typical High $7,244.36 | Professional | None | $3,090.30 | $5,011.87 | $7,244.36 |
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 $1,737.80 Median $1,905.46 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,737.80 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $758.58 Typical High $831.76 | Professional | 53 · Discontinued | $691.83 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $575.44 Typical High $630.96 | Professional | 55 · Aftercare only | $524.81 | $575.44 | $630.96 |
Where North Dakota sits
The same service costs 21.9 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
$7,244
AK $13,183TX $603
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.