How much rates vary
Facilitymedian $1,479 · 10th to 90th $617 to $4,786Professionalmedian $912 · 10th to 90th $468 to $1,230
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 $645.65 Median $3,388.44 Typical High $6,760.83 | Facility | None | $645.65 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,000.00 | Professional | None | $398.11 | $645.65 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,445.44 Typical High $1,698.24 | Facility | None | $389.05 | $1,445.44 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,122.02 | Professional | None | $831.76 | $954.99 | $1,122.02 |
Hally Health Setting Professional Modifier None Typical Low $380.19 Median $630.96 Typical High $851.14 | Professional | None | $380.19 | $630.96 | $851.14 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $1,148.15 Typical High $4,073.80 | Facility | None | $616.60 | $1,148.15 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $977.24 Typical High $3,311.31 | Professional | None | $501.19 | $977.24 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,122.02 | Professional | None | $794.33 | $933.25 | $1,122.02 |
Midlands Setting Facility Modifier None Typical Low $416.87 Median $1,412.54 Typical High $1,698.24 | Facility | None | $416.87 | $1,412.54 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,230.27 | Professional | None | $758.58 | $1,122.02 | $1,230.27 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $812.83 Typical High $1,071.52 | Professional | None | $446.68 | $812.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $4,897.79 | Facility | None | $501.19 | $1,949.84 | $4,897.79 |
United Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $1,148.15 | Professional | None | $407.38 | $602.56 | $1,148.15 |
Wellmark Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,230.27 | Professional | None | $870.96 | $1,023.29 | $1,230.27 |
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 $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $204.17 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $81.28 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $302.00 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $60.26 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $40.74 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $281.84 | $457.09 | $489.78 |
Where Iowa 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.