How much rates vary
Facilitymedian $1,413 · 10th to 90th $275 to $3,890Professionalmedian $251 · 10th to 90th $148 to $437
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 $169.82 Median $275.42 Typical High $851.14 | Facility | None | $169.82 | $275.42 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $363.08 | Professional | None | $169.82 | $275.42 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $331.13 | Professional | None | $147.91 | $234.42 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $1,348.96 | Facility | None | $158.49 | $257.04 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $263.03 | Professional | None | $144.54 | $223.87 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $977.24 Typical High $1,659.59 | Facility | None | $281.84 | $977.24 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $2,818.38 | Professional | None | $165.96 | $288.40 | $2,818.38 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $501.19 | Professional | None | $190.55 | $309.03 | $501.19 |
10 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 Facility Modifier 52 · Reduced service Typical Low $85.11 Median $123.03 Typical High $138.04 | Facility | 52 · Reduced service | $85.11 | $123.03 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $48.98 Typical High $56.23 | Facility | 53 · Discontinued | $33.88 | $48.98 | $56.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $186.21 Typical High $208.93 | Facility | 54 · Surgery only | $125.89 | $186.21 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $37.15 Typical High $41.69 | Facility | 55 · Aftercare only | $25.12 | $37.15 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $24.55 Typical High $27.54 | Facility | 56 · Pre-op care only | $16.98 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $123.03 Typical High $141.25 | Professional | 52 · Reduced service | $85.11 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $48.98 Typical High $56.23 | Professional | 53 · Discontinued | $33.88 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $125.89 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $37.15 Typical High $42.66 | Professional | 55 · Aftercare only | $25.12 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $24.55 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.98 | $24.55 | $28.18 |
Where Kentucky sits
The same service costs 7.0 times more in Vermont than in North Dakota. 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 $4,790ND $687
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.