How much rates vary
Facilitymedian $2,042 · 10th to 90th $851 to $3,162Professionalmedian $490 · 10th to 90th $363 to $692
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 $1,047.13 Typical High $2,398.83 | Facility | None | $398.11 | $1,047.13 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $489.78 | Professional | None | $398.11 | $457.09 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
BCBS Alabama Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $758.58 | Professional | None | $363.08 | $501.19 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,513.56 Typical High $1,905.46 | Facility | None | $549.54 | $1,513.56 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $707.95 | Professional | None | $426.58 | $457.09 | $707.95 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,265.80 | Facility | None | $758.58 | $1,737.80 | $4,265.80 |
United Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $831.76 | Professional | None | $346.74 | $446.68 | $831.76 |
7 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 Professional Modifier 52 · Reduced service Typical Low $199.53 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $79.43 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $363.08 | Professional | 54 · Surgery only | $295.12 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $338.84 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $3,019.95 Median $3,090.30 Typical High $3,090.30 | Facility | 50 · Both sides | $3,019.95 | $3,090.30 | $3,090.30 |
Where Alabama sits
The same service costs 7.2 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 $9,370ME $1,294
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.