How much rates vary
Facilitymedian $2,754 · 10th to 90th $851 to $5,888Professionalmedian $537 · 10th to 90th $407 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 $478.63 Median $1,737.80 Typical High $3,890.45 | Facility | None | $478.63 | $1,737.80 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $676.08 | Professional | None | $457.09 | $562.34 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $426.58 | Professional | None | $338.84 | $426.58 | $426.58 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1,548.82 Median $2,951.21 Typical High $6,606.93 | Facility | None | $1,548.82 | $2,951.21 | $6,606.93 |
BCBS Louisiana Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $588.84 | Professional | None | $457.09 | $489.78 | $588.84 |
Christus Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $2,691.53 | Facility | None | $524.81 | $1,071.52 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $870.96 | Professional | None | $380.19 | $575.44 | $870.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,548.82 Typical High $6,165.95 | Facility | None | $851.14 | $1,548.82 | $6,165.95 |
United Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $870.96 | Professional | None | $371.54 | $501.19 | $870.96 |
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 $269.15 Typical High $316.23 | Professional | 52 · Reduced service | $223.87 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $107.15 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $398.11 Typical High $467.74 | Professional | 54 · Surgery only | $338.84 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $93.33 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $371.54 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $316.23 | $371.54 | $436.52 |
Where Louisiana 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.