How much rates vary
Facilitymedian $1,549 · 10th to 90th $794 to $4,365Professionalmedian $603 · 10th to 90th $427 to $851
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 $512.86 Median $1,230.27 Typical High $2,454.71 | Facility | None | $512.86 | $1,230.27 | $2,454.71 |
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 $645.65 Median $676.08 Typical High $724.44 | Professional | None | $645.65 | $676.08 | $724.44 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $4,786.30 | Facility | None | $1,479.11 | $3,467.37 | $4,786.30 |
BCBS Arkansas Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $741.31 | Professional | None | $457.09 | $562.34 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,380.38 Typical High $1,819.70 | Facility | None | $562.34 | $1,380.38 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $724.44 Typical High $954.99 | Professional | None | $416.87 | $724.44 | $954.99 |
Qualchoice Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | None | $741.31 | $741.31 | $851.14 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $3,388.44 | Facility | None | $794.33 | $1,122.02 | $3,388.44 |
United Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $1,023.29 | Professional | None | $398.11 | $512.86 | $1,023.29 |
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 $245.47 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $407.38 |
Where Arkansas sits
The same service costs 4.7 times more in Vermont than in Montana. 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 $7,643MT $1,633
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.