How much rates vary
Facilitymedian $3,311 · 10th to 90th $575 to $7,079Professionalmedian $575 · 10th to 90th $417 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 $549.54 Median $1,479.11 Typical High $12,589.25 | Facility | None | $549.54 | $1,479.11 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $645.65 | Professional | None | $416.87 | $512.86 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | None | $446.68 | $446.68 | $512.86 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $812.83 Median $4,466.84 Typical High $7,585.78 | Facility | None | $812.83 | $4,466.84 | $7,585.78 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $676.08 | Professional | None | $478.63 | $616.60 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $2,137.96 | Facility | None | $630.96 | $1,778.28 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $676.08 | Professional | None | $416.87 | $549.54 | $676.08 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $691.83 Typical High $6,025.60 | Facility | None | $549.54 | $691.83 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $3,090.30 Typical High $3,801.89 | Professional | None | $446.68 | $3,090.30 | $3,801.89 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,235.94 Typical High $6,309.57 | Facility | None | $933.25 | $3,235.94 | $6,309.57 |
United Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $758.58 | Professional | None | $363.08 | $489.78 | $758.58 |
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 $208.93 Median $208.93 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $389.05 | Professional | 54 · Surgery only | $316.23 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $77.62 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $363.08 |
Where Oklahoma 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.