How much rates vary
Facilitymedian $2,630 · 10th to 90th $724 to $7,586Professionalmedian $759 · 10th to 90th $479 to $1,318
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 $602.56 Median $4,168.69 Typical High $7,244.36 | Facility | None | $602.56 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $870.96 | Professional | None | $316.23 | $512.86 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,096.48 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,148.15 | Professional | None | $707.95 | $831.76 | $1,148.15 |
Hally Health Setting Professional Modifier None Typical Low $295.12 Median $588.84 Typical High $891.25 | Professional | None | $295.12 | $588.84 | $891.25 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,318.26 Typical High $7,413.10 | Facility | None | $724.44 | $1,318.26 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $933.25 Typical High $3,630.78 | Professional | None | $549.54 | $933.25 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,122.02 | Professional | None | $616.60 | $912.01 | $1,122.02 |
Midlands Setting Facility Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,548.82 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $1,348.96 | Professional | None | $588.84 | $954.99 | $1,348.96 |
Oscar Health Setting Professional Modifier None Typical Low $331.13 Median $616.60 Typical High $1,047.13 | Professional | None | $331.13 | $616.60 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $1,148.15 | Professional | None | $354.81 | $588.84 | $1,148.15 |
Wellmark Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,230.27 | Professional | None | $645.65 | $758.58 | $1,230.27 |
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 $162.18 Median $257.04 Typical High $380.19 | Professional | 52 · Reduced service | $162.18 | $257.04 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $102.33 Typical High $151.36 | Professional | 53 · Discontinued | $66.07 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $389.05 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $77.62 Typical High $112.20 | Professional | 55 · Aftercare only | $48.98 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $51.29 Typical High $75.86 | Professional | 56 · Pre-op care only | $32.36 | $51.29 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $363.08 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $229.09 | $363.08 | $524.81 |
Where Iowa 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.