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 $1,148.15 Median $1,148.15 Typical High $1,318.26 | Facility | None | $1,148.15 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $954.99 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,041.74 | $2,630.27 | $3,090.30 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,454.71 Median $3,162.28 Typical High $3,715.35 | Professional | 22 · Increased work | $2,454.71 | $3,162.28 | $3,715.35 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,862.09 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,445.44 | $1,862.09 | $2,187.76 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $263.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $204.17 | $263.03 | $309.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,995.26 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,995.26 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,995.26 | $1,995.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,288.25 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,148.15 Typical High $2,398.83 | Facility | None | $758.58 | $1,148.15 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $2,137.96 Typical High $7,762.47 | Professional | None | $977.24 | $2,137.96 | $7,762.47 |
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 $954.99 Median $1,659.59 Typical High $2,511.89 | Professional | None | $954.99 | $1,659.59 | $2,511.89 |
1 more rate 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 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $204.17 |
Where North Dakota sits
The same service costs 16.2 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· 3rd of 51
$2,239
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.