How much rates vary
Facilitymedian $1,202 · 10th to 90th $417 to $2,630Professionalmedian $525 · 10th to 90th $316 to $724
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 $1,380.38 Typical High $7,762.47 | Facility | None | $407.38 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $562.34 | Professional | None | $380.19 | $524.81 | $562.34 |
BCBS New Mexico Setting Facility Modifier None Typical Low $489.78 Median $1,737.80 Typical High $2,691.53 | Facility | None | $489.78 | $1,737.80 | $2,691.53 |
BCBS New Mexico Setting Professional Modifier None Typical Low $229.09 Median $512.86 Typical High $794.33 | Professional | None | $229.09 | $512.86 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,513.56 | Facility | None | $776.25 | $1,174.90 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $691.83 | Professional | None | $398.11 | $537.03 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $380.19 Typical High $645.65 | Professional | None | $33.11 | $380.19 | $645.65 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $1,148.15 Typical High $1,778.28 | Facility | None | $426.58 | $1,148.15 | $1,778.28 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $758.58 | Professional | None | $398.11 | $562.34 | $758.58 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $3,019.95 | Facility | None | $346.74 | $707.95 | $3,019.95 |
United Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $776.25 | Professional | None | $354.81 | $562.34 | $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 $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $204.17 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $81.28 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $302.00 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $60.26 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $40.74 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $281.84 | $363.08 | $398.11 |
Where New Mexico 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.