How much rates vary
Facilitymedian $1,514 · 10th to 90th $575 to $5,754Professionalmedian $933 · 10th to 90th $427 to $1,380
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 $501.19 Median $5,754.40 Typical High $5,754.40 | Facility | None | $501.19 | $5,754.40 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $645.65 | Professional | None | $346.74 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,041.74 | Facility | None | $741.31 | $1,584.89 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,479.11 | Professional | None | $851.14 | $1,122.02 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $1,698.24 | Facility | None | $549.54 | $741.31 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $1,318.26 Typical High $3,801.89 | Professional | None | $446.68 | $1,318.26 | $3,801.89 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,122.02 | Professional | None | $933.25 | $954.99 | $1,122.02 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,737.80 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | None | $851.14 | $851.14 | $1,023.29 |
Sanford Health Plan Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,000.00 | Professional | None | $537.03 | $794.33 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $436.52 Median $1,071.52 Typical High $1,380.38 | Professional | None | $436.52 | $1,071.52 | $1,380.38 |
Wellmark Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,318.26 | Professional | None | $758.58 | $933.25 | $1,318.26 |
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 $173.78 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $173.78 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $81.28 Typical High $100.00 | Professional | 53 · Discontinued | $69.18 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $380.19 | Professional | 54 · Surgery only | $257.04 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $51.29 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $34.67 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $354.81 |
Where South Dakota 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.