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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,288.25 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $954.99 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,754.23 | $3,235.94 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,570.40 Median $3,311.31 Typical High $3,890.45 | Professional | 22 · Increased work | $2,570.40 | $3,311.31 | $3,890.45 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,949.84 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,513.56 | $1,949.84 | $2,290.87 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $275.42 Typical High $323.59 | Professional | 56 · Pre-op care only | $213.80 | $275.42 | $323.59 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $2,089.30 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,621.81 | $2,089.30 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,398.83 | Facility | None | $2,089.30 | $2,089.30 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,348.96 | $2,344.23 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,398.83 | Facility | None | $758.58 | $1,288.25 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $9,332.54 | Professional | None | $1,023.29 | $2,187.76 | $9,332.54 |
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 $1,047.13 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,778.28 | $2,570.40 |
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 $588.84 Median $645.65 Typical High $776.25 | Professional | 52 · Reduced service | $588.84 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $309.03 | Professional | 53 · Discontinued | $234.42 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $234.42 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $234.42 |
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
$2,455
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.