How much rates vary
Facilitymedian $1,549 · 10th to 90th $794 to $4,786Professionalmedian $537 · 10th to 90th $389 to $776
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 $446.68 Median $1,174.90 Typical High $2,454.71 | Facility | None | $446.68 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $616.60 | Professional | None | $416.87 | $512.86 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $776.25 | Professional | None | $524.81 | $588.84 | $776.25 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $4,786.30 | Facility | None | $1,479.11 | $3,467.37 | $4,786.30 |
BCBS Arkansas Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $676.08 | Professional | None | $416.87 | $512.86 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,380.38 Typical High $1,819.70 | Facility | None | $562.34 | $1,380.38 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $645.65 Typical High $851.14 | Professional | None | $380.19 | $645.65 | $851.14 |
Qualchoice Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $741.31 | Professional | None | $602.56 | $676.08 | $741.31 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $3,388.44 | Facility | None | $794.33 | $1,122.02 | $3,388.44 |
United Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $912.01 | Professional | None | $354.81 | $467.74 | $912.01 |
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 Professional Modifier 52 · Reduced service Typical Low $223.87 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $371.54 |
Where Arkansas 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.