How much rates vary
Facilitymedian $912 · 10th to 90th $309 to $1,995Professionalmedian $501 · 10th to 90th $389 to $676
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 $467.74 Median $1,071.52 Typical High $2,041.74 | Facility | None | $467.74 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $501.19 | Professional | None | $398.11 | $467.74 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
BCBS Arkansas Setting Facility Modifier None Typical Low $812.83 Median $1,445.44 Typical High $1,995.26 | Facility | None | $812.83 | $1,445.44 | $1,995.26 |
BCBS Arkansas Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $630.96 | Professional | None | $436.52 | $478.63 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $977.24 | Facility | None | $512.86 | $794.33 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $630.96 Typical High $676.08 | Professional | None | $331.13 | $630.96 | $676.08 |
Qualchoice Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $1,659.59 | Facility | None | $269.15 | $389.05 | $1,659.59 |
United Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $776.25 | Professional | None | $338.84 | $426.58 | $776.25 |
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 $204.17 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $93.33 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $331.13 | $354.81 |
Where Arkansas sits
The same service costs 4.5 times more in Vermont than in Florida. 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 $4,521FL $1,007
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.