How much rates vary
Facilitymedian $1,445 · 10th to 90th $501 to $6,026Professionalmedian $708 · 10th to 90th $380 to $1,148
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 $407.38 Median $4,466.84 Typical High $11,481.54 | Facility | None | $407.38 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $691.83 Typical High $1,071.52 | Professional | None | $380.19 | $691.83 | $1,071.52 |
BCBS Nebraska Setting Facility Modifier None Typical Low $3,388.44 Median $4,570.88 Typical High $9,120.11 | Facility | None | $3,388.44 | $4,570.88 | $9,120.11 |
BCBS Nebraska Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $812.83 | Professional | None | $331.13 | $588.84 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,258.93 Typical High $1,513.56 | Facility | None | $741.31 | $1,258.93 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,071.52 | Professional | None | $758.58 | $891.25 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $4,786.30 | Facility | None | $467.74 | $776.25 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $1,047.13 Typical High $3,311.31 | Professional | None | $524.81 | $1,047.13 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,230.27 | Professional | None | $891.25 | $977.24 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $691.83 Median $1,258.93 Typical High $1,621.81 | Facility | None | $691.83 | $1,258.93 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,348.96 | Professional | None | $707.95 | $1,202.26 | $1,348.96 |
United Setting Facility Modifier None Typical Low $467.74 Median $851.14 Typical High $2,754.23 | Facility | None | $467.74 | $851.14 | $2,754.23 |
United Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $1,071.52 | Professional | None | $512.86 | $851.14 | $1,071.52 |
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 $190.55 Median $204.17 Typical High $316.23 | Professional | 52 · Reduced service | $190.55 | $204.17 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $128.82 | Professional | 53 · Discontinued | $75.86 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $478.63 | Professional | 54 · Surgery only | $281.84 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $95.50 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $40.74 Typical High $63.10 | Professional | 56 · Pre-op care only | $38.02 | $40.74 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $446.68 |
Where Nebraska 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.