How much rates vary
Facilitymedian $398 · 10th to 90th $182 to $776Professionalmedian $1,000 · 10th to 90th $447 to $1,349
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 $446.68 Typical High $446.68 | Facility | None | $398.11 | $446.68 | $446.68 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $331.13 | Facility | 54 · Surgery only | $302.00 | $323.59 | $331.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $44.67 | Facility | 56 · Pre-op care only | $39.81 | $42.66 | $44.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $309.03 | Facility | 78 · Unplanned return to OR | $281.84 | $302.00 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $588.84 | Professional | None | $363.08 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $331.13 |
BCBS North Dakota Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,380.38 | Professional | None | $891.25 | $1,148.15 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $616.60 | $794.33 | $977.24 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $114.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $89.13 | $114.82 | $138.04 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $851.14 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $851.14 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $933.25 | Facility | None | $812.83 | $812.83 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $933.25 Typical High $1,348.96 | Professional | None | $436.52 | $933.25 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $398.11 Typical High $776.25 | Facility | None | $134.90 | $398.11 | $776.25 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $851.14 Typical High $3,162.28 | Professional | None | $457.09 | $851.14 | $3,162.28 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $891.25 | Professional | None | $416.87 | $758.58 | $891.25 |
8 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 $213.80 Typical High $218.78 | Facility | 52 · Reduced service | $199.53 | $213.80 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $89.13 | Facility | 53 · Discontinued | $79.43 | $85.11 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $66.07 | Facility | 55 · Aftercare only | $60.26 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $213.80 Typical High $239.88 | Professional | 52 · Reduced service | $199.53 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $95.50 | Professional | 53 · Discontinued | $79.43 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $72.44 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $1,071.52 Median $1,380.38 Typical High $1,659.59 | Professional | 22 · Increased work | $1,071.52 | $1,380.38 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,737.80 Typical High $2,089.30 | Professional | 50 · Both sides | $1,318.26 | $1,737.80 | $2,089.30 |
Where North Dakota sits
The same service costs 9.2 times more in Vermont than in Delaware. 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 $5,432DE $593
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.