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 $1,096.48 Median $1,096.48 Typical High $2,511.89 | Facility | None | $1,096.48 | $1,096.48 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $109.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $104.71 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $776.25 | $870.96 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,862.09 | $2,398.83 | $2,818.38 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,238.72 Median $2,884.03 Typical High $3,388.44 | Professional | 22 · Increased work | $2,238.72 | $2,884.03 | $3,388.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,659.59 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,288.25 | $1,659.59 | $1,949.84 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $239.88 Typical High $281.84 | Professional | 56 · Pre-op care only | $186.21 | $239.88 | $281.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,778.28 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,137.96 | Facility | None | $1,862.09 | $1,862.09 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,148.15 | $2,089.30 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $3,311.31 | Facility | None | $1,096.48 | $1,995.26 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,862.09 Typical High $8,128.31 | Professional | None | $870.96 | $1,862.09 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,995.26 | $3,019.95 | $3,235.94 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $2,187.76 | Professional | None | $870.96 | $1,479.11 | $2,187.76 |
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 $524.81 Median $549.54 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $549.54 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $208.93 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $165.96 | $186.21 |
Where North Dakota sits
The same service costs 5.2 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
$2,089
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.