How much rates vary
Facilitymedian $1,413 · 10th to 90th $759 to $5,495Professionalmedian $562 · 10th to 90th $355 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 $891.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $891.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $741.31 | Professional | None | $323.59 | $501.19 | $741.31 |
BCBS Kansas Setting Facility Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,318.26 | $1,412.54 | $1,412.54 |
BCBS Kansas Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $645.65 | Professional | None | $426.58 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,238.72 | Facility | None | $602.56 | $1,995.26 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $691.83 | Professional | None | $338.84 | $549.54 | $691.83 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,412.54 Typical High $26,302.68 | Facility | None | $549.54 | $1,412.54 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $2,398.83 Typical High $3,630.78 | Professional | None | $478.63 | $2,398.83 | $3,630.78 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $4,677.35 | Facility | None | $831.76 | $1,737.80 | $4,677.35 |
United Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $707.95 | Professional | None | $346.74 | $467.74 | $707.95 |
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 $251.19 Typical High $371.54 | Professional | 52 · Reduced service | $162.18 | $251.19 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $64.57 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $380.19 Typical High $549.54 | Professional | 54 · Surgery only | $245.47 | $380.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $75.86 Typical High $112.20 | Professional | 55 · Aftercare only | $48.98 | $75.86 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $50.12 Typical High $74.13 | Professional | 56 · Pre-op care only | $32.36 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $229.09 | $354.81 | $512.86 |
Where Kansas 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.