How much rates vary
Facilitymedian $794 · 10th to 90th $447 to $3,890Professionalmedian $1,047 · 10th to 90th $513 to $1,479
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $446.68 Median $549.54 Typical High $6,309.57 | Facility | None | $446.68 | $549.54 | $6,309.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $407.38 | Facility | 54 · Surgery only | $338.84 | $338.84 | $407.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $54.95 | Facility | 56 · Pre-op care only | $44.67 | $44.67 | $54.95 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $380.19 | Facility | 78 · Unplanned return to OR | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $691.83 | Professional | None | $407.38 | $467.74 | $691.83 |
BCBS North Dakota Setting Facility Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $3,890.45 | Facility | None | $2,398.83 | $2,570.40 | $3,890.45 |
BCBS North Dakota Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,513.56 | Professional | None | $912.01 | $1,122.02 | $1,513.56 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,071.52 Median $1,348.96 Typical High $1,819.70 | Professional | 22 · Increased work | $1,071.52 | $1,348.96 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,290.87 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $2,290.87 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $794.33 Typical High $1,047.13 | Professional | 54 · Surgery only | $630.96 | $794.33 | $1,047.13 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $112.20 Typical High $151.36 | Professional | 56 · Pre-op care only | $91.20 | $112.20 | $151.36 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $851.14 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $676.08 | $851.14 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Facility | None | $977.24 | $977.24 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,737.80 | Professional | None | $660.69 | $1,071.52 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $933.25 Typical High $2,630.27 | Facility | None | $446.68 | $933.25 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,174.90 | Professional | None | $575.44 | $1,000.00 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
United Setting Professional Modifier None Typical Low $478.63 Median $851.14 Typical High $1,071.52 | Professional | None | $478.63 | $851.14 | $1,071.52 |
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 Facility Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $275.42 | Facility | 52 · Reduced service | $223.87 | $223.87 | $275.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $109.65 | Facility | 53 · Discontinued | $91.20 | $91.20 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $83.18 | Facility | 55 · Aftercare only | $67.61 | $67.61 | $83.18 |
Where North Dakota sits
The same service costs 4.7 times more in Vermont than in Montana. 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.
Physician feeFacility fee
VT $7,643MT $1,633
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.