How much rates vary
Facilitymedian $1,000 · 10th to 90th $417 to $3,802Professionalmedian $417 · 10th to 90th $355 to $3,020
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 $977.24 Median $3,715.35 Typical High $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $407.38 | Professional | None | $380.19 | $398.11 | $407.38 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $891.25 | Professional | None | $501.19 | $602.56 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,000.00 Typical High $2,187.76 | Facility | None | $691.83 | $1,000.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $616.60 | Professional | None | $338.84 | $416.87 | $616.60 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $4,786.30 | Facility | None | $371.54 | $691.83 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $3,019.95 Typical High $3,311.31 | Professional | None | $363.08 | $3,019.95 | $3,311.31 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $588.84 | Professional | None | $331.13 | $380.19 | $588.84 |
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 $186.21 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $302.00 Typical High $309.03 | Professional | 54 · Surgery only | $281.84 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $61.66 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $281.84 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $263.03 | $281.84 | $288.40 |
Where Arizona 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.