How much rates vary
Facilitymedian $2,291 · 10th to 90th $229 to $5,623Professionalmedian $1,047 · 10th to 90th $309 to $3,090
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 $229.09 Median $2,238.72 Typical High $6,025.60 | Facility | None | $229.09 | $2,238.72 | $6,025.60 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $1,071.52 | Facility | 54 · Surgery only | $173.78 | $173.78 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $1,621.81 | Professional | None | $229.09 | $323.59 | $1,621.81 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,548.82 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,548.82 | $2,754.23 | $7,244.36 |
BCBS North Dakota Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $3,090.30 | Professional | None | $407.38 | $602.56 | $3,090.30 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $489.78 Median $724.44 Typical High $3,715.35 | Professional | 22 · Increased work | $489.78 | $724.44 | $3,715.35 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $426.58 Typical High $2,137.96 | Professional | 54 · Surgery only | $288.40 | $426.58 | $2,137.96 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $457.09 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $309.03 | $457.09 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,570.40 | Facility | None | $2,187.76 | $2,187.76 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $741.31 Typical High $3,467.37 | Professional | None | $331.13 | $741.31 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $1,862.09 Typical High $3,548.13 | Facility | None | $229.09 | $1,862.09 | $3,548.13 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $3,090.30 | Professional | None | $1,445.44 | $2,570.40 | $3,090.30 |
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 $245.47 Median $575.44 Typical High $2,754.23 | Professional | None | $245.47 | $575.44 | $2,754.23 |
4 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 $114.82 Median $114.82 Typical High $707.95 | Facility | 52 · Reduced service | $114.82 | $114.82 | $707.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $281.84 | Facility | 53 · Discontinued | $46.77 | $46.77 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $213.80 | Facility | 55 · Aftercare only | $34.67 | $34.67 | $213.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $141.25 | Facility | 56 · Pre-op care only | $22.91 | $22.91 | $141.25 |
Where North Dakota sits
The same service costs 4.3 times more in Vermont than in Maine. 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 $8,043ME $1,891
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.