How much rates vary
Facilitymedian $2,042 · 10th to 90th $631 to $5,623Professionalmedian $437 · 10th to 90th $295 to $2,399
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 $977.24 Median $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $489.78 | Professional | None | $295.12 | $436.52 | $489.78 |
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 Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $812.83 | Professional | None | $371.54 | $602.56 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,905.46 Typical High $3,388.44 | Facility | None | $758.58 | $1,905.46 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $602.56 | Professional | None | $288.40 | $407.38 | $602.56 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $1,513.56 Typical High $8,912.51 | Facility | None | $436.52 | $1,513.56 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $2,398.83 Typical High $3,630.78 | Professional | None | $398.11 | $2,398.83 | $3,630.78 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $575.44 | Professional | None | $275.42 | $389.05 | $575.44 |
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 $147.91 Median $190.55 Typical High $218.78 | Professional | 52 · Reduced service | $147.91 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $58.88 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $281.84 Typical High $323.59 | Professional | 54 · Surgery only | $218.78 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $44.67 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $29.51 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $263.03 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $208.93 | $263.03 | $302.00 |
Where Arizona 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.