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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,318.26 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,202.26 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $162.18 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $1,122.02 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,884.03 | $3,388.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,691.53 Median $3,467.37 Typical High $4,073.80 | Professional | 22 · Increased work | $2,691.53 | $3,467.37 | $4,073.80 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,041.74 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,584.89 | $2,041.74 | $2,398.83 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $288.40 Typical High $338.84 | Professional | 56 · Pre-op care only | $223.87 | $288.40 | $338.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,187.76 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,187.76 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,511.89 | Facility | None | $2,187.76 | $2,187.76 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,412.54 | $2,454.71 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,398.83 | Facility | None | $758.58 | $1,318.26 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $9,772.37 | Professional | None | $1,071.52 | $2,238.72 | $9,772.37 |
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 $1,071.52 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,862.09 | $2,630.27 |
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 $602.56 Median $660.69 Typical High $812.83 | Professional | 52 · Reduced service | $602.56 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $245.47 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $239.88 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $239.88 |
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· 8th of 51
$2,512
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.