How much rates vary
Facilitymedian $1,479 · 10th to 90th $708 to $4,786Professionalmedian $617 · 10th to 90th $380 to $977
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 $416.87 Median $794.33 Typical High $1,819.70 | Facility | None | $416.87 | $794.33 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $741.31 Typical High $977.24 | Professional | None | $354.81 | $741.31 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $537.03 | Professional | None | $338.84 | $426.58 | $537.03 |
BCBS Mississippi Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
BCBS Mississippi Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,513.56 Typical High $3,090.30 | Facility | None | $660.69 | $1,513.56 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $630.96 Typical High $831.76 | Professional | None | $380.19 | $630.96 | $831.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $6,760.83 | Facility | None | $758.58 | $1,412.54 | $6,760.83 |
United Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $912.01 | Professional | None | $380.19 | $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 $177.83 Median $398.11 Typical High $489.78 | Professional | 52 · Reduced service | $177.83 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $158.49 Typical High $194.98 | Professional | 53 · Discontinued | $70.79 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $269.15 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $53.70 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $79.43 Typical High $97.72 | Professional | 56 · Pre-op care only | $35.48 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $549.54 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $251.19 | $549.54 | $676.08 |
Where Mississippi 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.