How much rates vary
Facilitymedian $1,380 · 10th to 90th $186 to $2,692Professionalmedian $955 · 10th to 90th $263 to $2,754
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 $186.21 Median $933.25 Typical High $1,621.81 | Facility | None | $186.21 | $933.25 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $831.76 Typical High $1,023.29 | Professional | None | $186.21 | $831.76 | $1,023.29 |
BCBS Minnesota Setting Facility Modifier None Typical Low $123.03 Median $1,047.13 Typical High $1,905.46 | Facility | None | $123.03 | $1,047.13 | $1,905.46 |
BCBS Minnesota Setting Professional Modifier None Typical Low $295.12 Median $1,122.02 Typical High $2,398.83 | Professional | None | $295.12 | $1,122.02 | $2,398.83 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $1,659.59 Typical High $3,548.13 | Professional | 50 · Both sides | $436.52 | $1,659.59 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $3,981.07 | Facility | None | $1,258.93 | $2,089.30 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $1,174.90 Typical High $3,467.37 | Professional | None | $363.08 | $1,174.90 | $3,467.37 |
Health Partners Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,202.26 | $1,949.84 | $3,388.44 |
Health Partners Setting Professional Modifier None Typical Low $338.84 Median $1,122.02 Typical High $2,818.38 | Professional | None | $338.84 | $1,122.02 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $436.52 Typical High $2,137.96 | Facility | None | $125.89 | $436.52 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $3,801.89 | Professional | None | $1,096.48 | $1,862.09 | $3,801.89 |
United Setting Facility Modifier None Typical Low $125.89 Median $389.05 Typical High $1,778.28 | Facility | None | $125.89 | $389.05 | $1,778.28 |
United Setting Professional Modifier None Typical Low $251.19 Median $758.58 Typical High $3,162.28 | Professional | None | $251.19 | $758.58 | $3,162.28 |
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 $91.20 Median $467.74 Typical High $467.74 | Facility | 52 · Reduced service | $91.20 | $467.74 | $467.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $186.21 Typical High $186.21 | Facility | 53 · Discontinued | $37.15 | $186.21 | $186.21 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $691.83 Typical High $691.83 | Facility | 54 · Surgery only | $138.04 | $691.83 | $691.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $138.04 Typical High $138.04 | Facility | 55 · Aftercare only | $27.54 | $138.04 | $138.04 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $93.33 Typical High $93.33 | Facility | 56 · Pre-op care only | $18.62 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $91.20 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $37.15 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $138.04 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $27.54 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $18.62 | $93.33 | $93.33 |
Where Minnesota sits
The same service costs 11.7 times more in Vermont than in Maryland. 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 $7,161MD $610
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.