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 $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $707.95 | Professional | None | $616.60 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $501.19 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,513.56 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,412.54 Median $1,778.28 Typical High $2,089.30 | Professional | 22 · Increased work | $1,412.54 | $1,778.28 | $2,089.30 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,230.27 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $117.49 | $151.36 | $177.83 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,122.02 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $1,122.02 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Facility | None | $1,122.02 | $1,122.02 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,230.27 Typical High $1,737.80 | Professional | None | $676.08 | $1,230.27 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $2,344.23 | Facility | None | $645.65 | $831.76 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $1,071.52 Typical High $4,897.79 | Professional | None | $537.03 | $1,071.52 | $4,897.79 |
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 $537.03 Median $870.96 Typical High $1,258.93 | Professional | None | $537.03 | $870.96 | $1,258.93 |
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 $309.03 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $107.15 |
Where North Dakota sits
The same service costs 5.4 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· 9th of 51
$1,230
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.