How much rates vary
Facilitymedian $589 · 10th to 90th $427 to $1,122Professionalmedian $891 · 10th to 90th $447 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 $398.11 Median $426.58 Typical High $4,365.16 | Facility | None | $398.11 | $426.58 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $457.09 | Professional | None | $346.74 | $380.19 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $1,122.02 | Facility | None | $371.54 | $831.76 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,230.27 | Professional | None | $741.31 | $954.99 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $588.84 Typical High $954.99 | Facility | None | $446.68 | $588.84 | $954.99 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $1,047.13 Typical High $3,311.31 | Professional | None | $389.05 | $1,047.13 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $977.24 | Professional | None | $891.25 | $891.25 | $977.24 |
Midlands Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $1,174.90 | Facility | None | $371.54 | $954.99 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | None | $812.83 | $870.96 | $933.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $912.01 | Professional | None | $446.68 | $707.95 | $912.01 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $380.19 Median $831.76 Typical High $1,174.90 | Professional | None | $380.19 | $831.76 | $1,174.90 |
Wellmark Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,258.93 | Professional | None | $912.01 | $1,071.52 | $1,258.93 |
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 $173.78 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $173.78 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $69.18 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $34.67 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $263.03 | $316.23 |
Where South Dakota 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.