How much rates vary
Facilitymedian $427 · 10th to 90th $398 to $776Professionalmedian $871 · 10th to 90th $427 to $1,175
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 $398.11 Median $426.58 Typical High $426.58 | Facility | None | $398.11 | $426.58 | $426.58 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $323.59 | Facility | 54 · Surgery only | $295.12 | $309.03 | $323.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $42.66 | Facility | 56 · Pre-op care only | $39.81 | $41.69 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $302.00 | Facility | 78 · Unplanned return to OR | $275.42 | $288.40 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $457.09 | Professional | None | $363.08 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $316.23 |
BCBS North Dakota Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,202.26 | Professional | None | $794.33 | $1,000.00 | $1,202.26 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $954.99 Median $1,202.26 Typical High $1,412.54 | Professional | 22 · Increased work | $954.99 | $1,202.26 | $1,412.54 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,479.11 Typical High $1,778.28 | Professional | 50 · Both sides | $1,174.90 | $1,479.11 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $549.54 | $691.83 | $831.76 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $79.43 | $100.00 | $120.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $741.31 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $588.84 | $741.31 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $891.25 | Facility | None | $776.25 | $776.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $891.25 Typical High $1,288.25 | Professional | None | $457.09 | $891.25 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $467.74 Typical High $776.25 | Facility | None | $398.11 | $467.74 | $776.25 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $3,019.95 | Professional | None | $446.68 | $831.76 | $3,019.95 |
United Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $758.58 | Facility | None | $446.68 | $616.60 | $758.58 |
United Setting Professional Modifier None Typical Low $407.38 Median $741.31 Typical High $891.25 | Professional | None | $407.38 | $741.31 | $891.25 |
6 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 $199.53 Median $208.93 Typical High $213.80 | Facility | 52 · Reduced service | $199.53 | $208.93 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $85.11 | Facility | 53 · Discontinued | $79.43 | $83.18 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $64.57 | Facility | 55 · Aftercare only | $58.88 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $67.61 |
Where North Dakota sits
The same service costs 4.5 times more in Vermont than in Florida. 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 $4,521FL $1,007
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.