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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,122.02 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $776.25 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $112.20 Typical High $138.04 | Professional | 56 · Pre-op care only | $104.71 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $954.99 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $2,951.21 | Professional | None | $1,949.84 | $2,511.89 | $2,951.21 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,290.87 Median $3,019.95 Typical High $3,548.13 | Professional | 22 · Increased work | $2,290.87 | $3,019.95 | $3,548.13 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,737.80 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,348.96 | $1,737.80 | $2,041.74 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $251.19 Typical High $295.12 | Professional | 56 · Pre-op care only | $194.98 | $251.19 | $295.12 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,862.09 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,862.09 | $2,187.76 |
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 $1,202.26 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,202.26 | $2,089.30 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,122.02 Typical High $2,398.83 | Facility | None | $758.58 | $1,122.02 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,905.46 Typical High $8,317.64 | Professional | None | $912.01 | $1,905.46 | $8,317.64 |
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 $933.25 Median $1,584.89 Typical High $2,238.72 | Professional | None | $933.25 | $1,584.89 | $2,238.72 |
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 $562.34 Typical High $676.08 | Professional | 52 · Reduced service | $524.81 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $275.42 | Professional | 53 · Discontinued | $208.93 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $154.88 | $169.82 | $204.17 |
Where North Dakota sits
The same service costs 5.6 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
$2,188
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.