How much rates vary
Facilitymedian $661 · 10th to 90th $234 to $5,623Professionalmedian $347 · 10th to 90th $81 to $575
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 $457.09 Median $3,019.95 Typical High $10,964.78 | Facility | None | $457.09 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $457.09 | Professional | None | $309.03 | $346.74 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
AvMed Setting Facility Modifier None Typical Low $239.88 Median $1,288.25 Typical High $9,549.93 | Facility | None | $239.88 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $524.81 | Professional | None | $380.19 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,023.29 Typical High $2,187.76 | Facility | None | $436.52 | $1,023.29 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $616.60 | Professional | None | $288.40 | $331.13 | $616.60 |
Florida Blue Setting Facility Modifier None Typical Low $213.80 Median $467.74 Typical High $6,309.57 | Facility | None | $213.80 | $467.74 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $165.96 Median $389.05 Typical High $537.03 | Professional | None | $165.96 | $389.05 | $537.03 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $323.59 Typical High $588.84 | Professional | None | $31.62 | $323.59 | $588.84 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $691.83 | Professional | None | $269.15 | $354.81 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | None | $323.59 | $380.19 | $380.19 |
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 $154.88 Median $173.78 Typical High $229.09 | Professional | 52 · Reduced service | $154.88 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $69.18 Typical High $91.20 | Professional | 53 · Discontinued | $61.66 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $229.09 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $67.61 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $34.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.90 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $245.47 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $213.80 | $245.47 | $316.23 |
Where Florida 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.