How much rates vary
Facilitymedian $2,042 · 10th to 90th $631 to $5,623Professionalmedian $479 · 10th to 90th $363 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 $977.24 Median $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $870.96 | Professional | None | $363.08 | $457.09 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $912.01 | Professional | None | $338.84 | $478.63 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,862.09 Typical High $3,311.31 | Facility | None | $758.58 | $1,862.09 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $812.83 | Professional | None | $380.19 | $512.86 | $812.83 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $1,621.81 Typical High $8,709.64 | Facility | None | $478.63 | $1,621.81 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $3,090.30 Typical High $3,801.89 | Professional | None | $436.52 | $3,090.30 | $3,801.89 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $851.14 | Professional | None | $363.08 | $457.09 | $851.14 |
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 $181.97 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $181.97 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $72.44 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $275.42 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $36.31 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $257.04 | $302.00 | $316.23 |
Where Arizona 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.