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 $1,230.27 Median $1,230.27 Typical High $6,456.54 | Facility | None | $1,230.27 | $1,230.27 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $3,388.44 | Professional | None | $1,122.02 | $1,230.27 | $3,388.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $912.01 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $954.99 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $3,162.28 | Professional | None | $2,089.30 | $2,691.53 | $3,162.28 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,511.89 Median $3,235.94 Typical High $3,801.89 | Professional | 22 · Increased work | $2,511.89 | $3,235.94 | $3,801.89 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,862.09 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,445.44 | $1,862.09 | $2,238.72 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $269.15 Typical High $316.23 | Professional | 56 · Pre-op care only | $208.93 | $269.15 | $316.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,995.26 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,995.26 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,344.23 | Facility | None | $2,041.74 | $2,041.74 | $2,344.23 |
Cigna 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 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,230.27 | $3,981.07 | $10,232.93 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $2,089.30 Typical High $9,120.11 | Professional | None | $1,023.29 | $2,089.30 | $9,120.11 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $7,943.28 Typical High $12,302.69 | Facility | None | $3,981.07 | $7,943.28 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,698.24 | $2,454.71 |
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 $562.34 Median $616.60 Typical High $676.08 | Professional | 52 · Reduced service | $562.34 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $204.17 |
Where North Dakota sits
The same service costs 25.7 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· 10th of 51
$2,344
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.