How much rates vary
Facilitymedian $2,692 · 10th to 90th $871 to $5,888Professionalmedian $589 · 10th to 90th $447 to $871
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 $1,737.80 Typical High $3,890.45 | Facility | None | $549.54 | $1,737.80 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $758.58 | Professional | None | $501.19 | $630.96 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $6,606.93 | Facility | None | $1,548.82 | $2,884.03 | $6,606.93 |
BCBS Louisiana Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $645.65 | Professional | None | $501.19 | $537.03 | $645.65 |
Christus Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $2,691.53 | Facility | None | $524.81 | $1,071.52 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $954.99 | Professional | None | $426.58 | $630.96 | $954.99 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,548.82 Typical High $6,165.95 | Facility | None | $851.14 | $1,548.82 | $6,165.95 |
United Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $977.24 | Professional | None | $416.87 | $562.34 | $977.24 |
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 $251.19 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $251.19 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $100.00 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $380.19 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $75.86 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $50.12 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $416.87 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $354.81 | $416.87 | $489.78 |
Where Louisiana 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.