How much rates vary
Facilitymedian $490 · 10th to 90th $316 to $2,570Professionalmedian $759 · 10th to 90th $407 to $1,202
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 $316.23 Median $489.78 Typical High $489.78 | Facility | None | $316.23 | $489.78 | $489.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $245.47 Typical High $371.54 | Facility | 54 · Surgery only | $239.88 | $245.47 | $371.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $48.98 | Facility | 56 · Pre-op care only | $31.62 | $32.36 | $48.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $229.09 Typical High $346.74 | Facility | 78 · Unplanned return to OR | $223.87 | $229.09 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $588.84 | Professional | None | $288.40 | $407.38 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $302.00 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $39.81 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $281.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $223.87 | $281.84 | $346.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,202.26 | Professional | None | $616.60 | $831.76 | $1,202.26 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $741.31 Median $1,000.00 Typical High $1,445.44 | Professional | 22 · Increased work | $741.31 | $1,000.00 | $1,445.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $575.44 Typical High $851.14 | Professional | 54 · Surgery only | $436.52 | $575.44 | $851.14 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $83.18 Typical High $120.23 | Professional | 56 · Pre-op care only | $61.66 | $83.18 | $120.23 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $616.60 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $467.74 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $954.99 | Facility | None | $831.76 | $831.76 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $812.83 Typical High $1,318.26 | Professional | None | $457.09 | $812.83 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $831.76 Typical High $2,630.27 | Facility | None | $316.23 | $831.76 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $912.01 Typical High $2,398.83 | Professional | None | $501.19 | $912.01 | $2,398.83 |
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 $331.13 Median $602.56 Typical High $977.24 | Professional | None | $331.13 | $602.56 | $977.24 |
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 $158.49 Median $162.18 Typical High $245.47 | Facility | 52 · Reduced service | $158.49 | $162.18 | $245.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $97.72 | Facility | 53 · Discontinued | $63.10 | $66.07 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $74.13 | Facility | 55 · Aftercare only | $47.86 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $199.53 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $79.43 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $60.26 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $60.26 | $74.13 |
Where North Dakota sits
The same service costs 11.0 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 $12,892MT $1,170
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.