How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,096 to $8,318Professionalmedian $589 · 10th to 90th $302 to $1,230
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 $446.68 Median $7,244.36 Typical High $17,378.01 | Facility | None | $446.68 | $7,244.36 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $1,174.90 | Professional | None | $302.00 | $562.34 | $1,174.90 |
BCBS Nebraska Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $12,882.50 | Facility | None | $4,786.30 | $6,456.54 | $12,882.50 |
BCBS Nebraska Setting Professional Modifier None Typical Low $263.03 Median $478.63 Typical High $660.69 | Professional | None | $263.03 | $478.63 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,089.30 Typical High $2,884.03 | Facility | None | $1,096.48 | $2,089.30 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,148.15 | Professional | None | $630.96 | $954.99 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $7,943.28 | Facility | None | $831.76 | $1,819.70 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,174.90 Typical High $3,630.78 | Professional | None | $602.56 | $1,174.90 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,230.27 | Professional | None | $741.31 | $1,000.00 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $3,019.95 | Facility | None | $1,096.48 | $2,344.23 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,479.11 | Professional | None | $562.34 | $1,000.00 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,174.90 | $1,862.09 | $5,495.41 |
United Setting Professional Modifier None Typical Low $426.58 Median $741.31 Typical High $1,202.26 | Professional | None | $426.58 | $741.31 | $1,202.26 |
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 $151.36 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $151.36 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $60.26 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $331.13 Typical High $380.19 | Professional | 54 · Surgery only | $223.87 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $66.07 Typical High $75.86 | Professional | 55 · Aftercare only | $44.67 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $30.20 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $309.03 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $208.93 | $309.03 | $354.81 |
Where Nebraska 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.