How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $12,303Professionalmedian $437 · 10th to 90th $87 to $851
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 $2,818.38 Typical High $11,481.54 | Facility | None | $398.11 | $2,818.38 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $851.14 | Professional | None | $331.13 | $426.58 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $741.31 | Professional | None | $407.38 | $467.74 | $741.31 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $9,772.37 | Facility | None | $501.19 | $1,949.84 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $616.60 | Professional | None | $426.58 | $489.78 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $11,481.54 | Facility | None | $512.86 | $1,949.84 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $870.96 | Professional | None | $323.59 | $457.09 | $870.96 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $2,089.30 Typical High $16,982.44 | Facility | None | $977.24 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $549.54 | Professional | None | $338.84 | $407.38 | $549.54 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $416.87 Typical High $891.25 | Professional | None | $72.44 | $416.87 | $891.25 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $7,585.78 | Facility | None | $794.33 | $1,905.46 | $7,585.78 |
United Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $1,000.00 | Professional | None | $316.23 | $512.86 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $446.68 | Professional | None | $316.23 | $446.68 | $446.68 |
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 $165.96 Median $190.55 Typical High $239.88 | Professional | 52 · Reduced service | $165.96 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $75.86 Typical High $97.72 | Professional | 53 · Discontinued | $66.07 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $245.47 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $72.44 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $263.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $229.09 | $263.03 | $338.84 |
Where Florida 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.