How much rates vary
Facilitymedian $2,291 · 10th to 90th $891 to $7,943Professionalmedian $1,047 · 10th to 90th $575 to $1,585
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 $870.96 Median $1,698.24 Typical High $6,606.93 | Facility | None | $870.96 | $1,698.24 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $1,380.38 | Professional | None | $426.58 | $691.83 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,398.83 Typical High $3,162.28 | Facility | None | $1,096.48 | $2,398.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $933.25 | $1,288.25 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $741.31 Typical High $1,230.27 | Professional | None | $426.58 | $741.31 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $8,317.64 | Facility | None | $794.33 | $1,513.56 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $3,388.44 | Professional | None | $616.60 | $1,258.93 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,288.25 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $2,398.83 Typical High $3,162.28 | Facility | None | $1,445.44 | $2,398.83 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,778.28 | Professional | None | $870.96 | $1,230.27 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $512.86 Median $933.25 Typical High $1,412.54 | Professional | None | $512.86 | $933.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $10,232.93 | Facility | None | $1,258.93 | $3,630.78 | $10,232.93 |
United Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,445.44 | Professional | None | $501.19 | $831.76 | $1,445.44 |
Wellmark Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,412.54 | Professional | None | $851.14 | $1,000.00 | $1,412.54 |
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 $213.80 Median $346.74 Typical High $436.52 | Professional | 52 · Reduced service | $213.80 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $85.11 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $524.81 Typical High $645.65 | Professional | 54 · Surgery only | $316.23 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $104.71 Typical High $128.82 | Professional | 55 · Aftercare only | $63.10 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $69.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $42.66 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $489.78 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $295.12 | $489.78 | $602.56 |
Where Iowa 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.