How much rates vary
Facilitymedian $4,266 · 10th to 90th $646 to $10,471Professionalmedian $457 · 10th to 90th $324 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 $1,000.00 Median $3,981.07 Typical High $12,589.25 | Facility | None | $1,000.00 | $3,981.07 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $501.19 | Professional | None | $331.13 | $436.52 | $501.19 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,348.96 Median $6,760.83 Typical High $11,748.98 | Facility | None | $1,348.96 | $6,760.83 | $11,748.98 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $630.96 | Professional | None | $302.00 | $457.09 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $2,187.76 | Facility | None | $630.96 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $562.34 | Professional | None | $380.19 | $446.68 | $562.34 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $660.69 Typical High $6,025.60 | Facility | None | $436.52 | $660.69 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $2,398.83 Typical High $3,630.78 | Professional | None | $416.87 | $2,398.83 | $3,630.78 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $575.44 | Professional | None | $275.42 | $398.11 | $575.44 |
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 $165.96 Median $165.96 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $66.07 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | 54 · Surgery only | $251.19 | $251.19 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $74.13 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $346.74 |
Where Oklahoma 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.