How much rates vary
Facilitymedian $2,455 · 10th to 90th $933 to $5,754Professionalmedian $525 · 10th to 90th $347 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 $524.81 Median $1,862.09 Typical High $3,801.89 | Facility | None | $524.81 | $1,862.09 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $724.44 | Professional | None | $389.05 | $549.54 | $724.44 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $6,309.57 | Facility | None | $1,819.70 | $2,818.38 | $6,309.57 |
BCBS Louisiana Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $758.58 | Professional | None | $407.38 | $524.81 | $758.58 |
Christus Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $2,691.53 | Facility | None | $524.81 | $1,071.52 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $812.83 | Professional | None | $354.81 | $537.03 | $812.83 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,548.82 Typical High $5,888.44 | Facility | None | $851.14 | $1,548.82 | $5,888.44 |
United Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $724.44 | Professional | None | $295.12 | $446.68 | $724.44 |
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 $194.98 Median $275.42 Typical High $363.08 | Professional | 52 · Reduced service | $194.98 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $109.65 Typical High $144.54 | Professional | 53 · Discontinued | $77.62 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $407.38 Typical High $537.03 | Professional | 54 · Surgery only | $288.40 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $81.28 Typical High $107.15 | Professional | 55 · Aftercare only | $57.54 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $54.95 Typical High $72.44 | Professional | 56 · Pre-op care only | $38.90 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $380.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $269.15 | $380.19 | $501.19 |
Where Louisiana 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.