How much rates vary
Facilitymedian $1,514 · 10th to 90th $708 to $4,467Professionalmedian $525 · 10th to 90th $288 to $955
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 $416.87 Median $776.25 Typical High $1,995.26 | Facility | None | $416.87 | $776.25 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $707.95 Typical High $1,023.29 | Professional | None | $288.40 | $707.95 | $1,023.29 |
BCBS Mississippi Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
BCBS Mississippi Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,584.89 Typical High $3,019.95 | Facility | None | $660.69 | $1,584.89 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $776.25 | Professional | None | $354.81 | $524.81 | $776.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $6,025.60 | Facility | None | $758.58 | $1,412.54 | $6,025.60 |
United Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $891.25 | Professional | None | $295.12 | $436.52 | $891.25 |
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 $144.54 Median $354.81 Typical High $501.19 | Professional | 52 · Reduced service | $144.54 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $141.25 Typical High $204.17 | Professional | 53 · Discontinued | $57.54 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $524.81 Typical High $758.58 | Professional | 54 · Surgery only | $218.78 | $524.81 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $104.71 Typical High $151.36 | Professional | 55 · Aftercare only | $43.65 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $70.79 Typical High $102.33 | Professional | 56 · Pre-op care only | $28.84 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $489.78 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $204.17 | $489.78 | $707.95 |
Where Mississippi 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.