How much rates vary
Facilitymedian $1,905 · 10th to 90th $759 to $11,749Professionalmedian $339 · 10th to 90th $83 to $562
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 $524.81 Median $4,265.80 Typical High $11,748.98 | Facility | None | $524.81 | $4,265.80 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $501.19 | Professional | None | $251.19 | $338.84 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
AvMed Setting Facility Modifier None Typical Low $489.78 Median $1,905.46 Typical High $9,549.93 | Facility | None | $489.78 | $1,905.46 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $524.81 | Professional | None | $316.23 | $398.11 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $3,019.95 | Facility | None | $501.19 | $1,905.46 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $588.84 | Professional | None | $229.09 | $338.84 | $588.84 |
Florida Blue Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $16,982.44 | Facility | None | $870.96 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $537.03 | Professional | None | $173.78 | $389.05 | $537.03 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $281.84 Typical High $575.44 | Professional | None | $31.62 | $281.84 | $575.44 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $676.08 | Professional | None | $218.78 | $346.74 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $389.05 | Professional | None | $239.88 | $389.05 | $389.05 |
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 $123.03 Median $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $123.03 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $67.61 Typical High $91.20 | Professional | 53 · Discontinued | $50.12 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $257.04 Typical High $338.84 | Professional | 54 · Surgery only | $186.21 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $37.15 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $25.12 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $239.88 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $173.78 | $239.88 | $316.23 |
Where Florida 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.