How much rates vary
Facilitymedian $2,291 · 10th to 90th $832 to $7,943Professionalmedian $955 · 10th to 90th $513 to $1,445
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 $776.25 Median $1,548.82 Typical High $6,606.93 | Facility | None | $776.25 | $1,548.82 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $630.96 Typical High $1,258.93 | Professional | None | $371.54 | $630.96 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,398.83 Typical High $3,162.28 | Facility | None | $1,096.48 | $2,398.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,445.44 | Professional | None | $870.96 | $1,148.15 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $1,122.02 | Professional | None | $389.05 | $676.08 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,412.54 Typical High $8,317.64 | Facility | None | $724.44 | $1,412.54 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,122.02 Typical High $3,090.30 | Professional | None | $575.44 | $1,122.02 | $3,090.30 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,445.44 | Professional | None | $954.99 | $1,148.15 | $1,445.44 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $2,398.83 Typical High $3,162.28 | Facility | None | $1,445.44 | $2,398.83 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $776.25 | $1,122.02 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $457.09 Median $831.76 Typical High $1,258.93 | Professional | None | $457.09 | $831.76 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $10,232.93 | Facility | None | $1,258.93 | $3,630.78 | $10,232.93 |
United Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $1,288.25 | Professional | None | $457.09 | $758.58 | $1,288.25 |
Wellmark Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,258.93 | Professional | None | $758.58 | $891.25 | $1,258.93 |
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 $190.55 Median $316.23 Typical High $389.05 | Professional | 52 · Reduced service | $190.55 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $125.89 Typical High $158.49 | Professional | 53 · Discontinued | $75.86 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $478.63 Typical High $588.84 | Professional | 54 · Surgery only | $288.40 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $95.50 Typical High $117.49 | Professional | 55 · Aftercare only | $57.54 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $38.02 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $446.68 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $269.15 | $446.68 | $549.54 |
Where Iowa 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.