How much rates vary
Facilitymedian $3,162 · 10th to 90th $851 to $3,162Professionalmedian $525 · 10th to 90th $302 to $759
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 $707.95 Median $1,096.48 Typical High $2,089.30 | Facility | None | $707.95 | $1,096.48 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $758.58 | Professional | None | $416.87 | $524.81 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,548.82 Typical High $1,949.84 | Facility | None | $549.54 | $1,548.82 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $562.34 | Professional | None | $346.74 | $398.11 | $562.34 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,168.69 | Facility | None | $758.58 | $1,737.80 | $4,168.69 |
United Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $660.69 | Professional | None | $263.03 | $389.05 | $660.69 |
7 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 $263.03 Median $263.03 Typical High $380.19 | Professional | 52 · Reduced service | $263.03 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $151.36 | Professional | 53 · Discontinued | $104.71 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $389.05 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $114.82 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $75.86 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $537.03 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $338.84 Median $467.74 Typical High $630.96 | Professional | 32 · Mandated service | $338.84 | $467.74 | $630.96 |
Where Alabama sits
The same service costs 11.0 times more in Vermont than in Montana. 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 $12,892MT $1,170
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.