How much rates vary
Facilitymedian $1,349 · 10th to 90th $129 to $9,333Professionalmedian $741 · 10th to 90th $174 to $1,318
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 $346.74 Median $2,238.72 Typical High $10,715.19 | Facility | None | $346.74 | $2,238.72 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $870.96 Typical High $2,754.23 | Professional | None | $190.55 | $870.96 | $2,754.23 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $151.36 Typical High $389.05 | Professional | None | $75.86 | $151.36 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $10,715.19 Typical High $18,620.87 | Facility | None | $3,630.78 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $338.84 Typical High $1,071.52 | Professional | None | $162.18 | $338.84 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $478.63 Typical High $1,621.81 | Professional | 50 · Both sides | $239.88 | $478.63 | $1,621.81 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $537.03 Typical High $812.83 | Facility | None | $213.80 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,290.87 Typical High $2,691.53 | Facility | None | $524.81 | $2,290.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $446.68 Typical High $1,258.93 | Professional | None | $169.82 | $446.68 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $575.44 Median $2,290.87 Typical High $3,630.78 | Facility | None | $575.44 | $2,290.87 | $3,630.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $169.82 Median $446.68 Typical High $1,258.93 | Professional | None | $169.82 | $446.68 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,174.90 | Professional | None | $724.44 | $912.01 | $1,174.90 |
SummaCare Setting Professional Modifier None Typical Low $158.49 Median $794.33 Typical High $1,174.90 | Professional | None | $158.49 | $794.33 | $1,174.90 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $194.98 Median $812.83 Typical High $1,584.89 | Professional | None | $194.98 | $812.83 | $1,584.89 |
5 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 $95.50 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $95.50 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $38.02 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $141.25 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $28.18 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $19.05 | $87.10 | $95.50 |
Where Ohio 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.