How much rates vary
Facilitymedian $417 · 10th to 90th $135 to $3,548Professionalmedian $1,122 · 10th to 90th $214 to $2,042
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 $213.80 Median $2,754.23 Typical High $20,417.38 | Facility | None | $213.80 | $2,754.23 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $831.76 Typical High $1,380.38 | Professional | None | $173.78 | $831.76 | $1,380.38 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $114.82 Typical High $1,047.13 | Facility | None | $30.20 | $114.82 | $1,047.13 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $269.15 Median $1,778.28 Typical High $7,079.46 | Professional | None | $269.15 | $1,778.28 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $2,691.53 | Facility | None | $891.25 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $562.34 Typical High $1,905.46 | Professional | None | $208.93 | $562.34 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $524.81 Typical High $2,137.96 | Professional | None | $302.00 | $524.81 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $1,258.93 Typical High $1,995.26 | Professional | None | $218.78 | $1,258.93 | $1,995.26 |
Pacific Source Setting Facility Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,698.24 | Facility | None | $1,202.26 | $1,548.82 | $1,698.24 |
Premera BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,122.02 | $1,174.90 | $1,174.90 |
Premera BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $1,122.02 | Professional | None | $229.09 | $229.09 | $1,122.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $524.81 Typical High $1,995.26 | Professional | None | $234.42 | $524.81 | $1,995.26 |
United Setting Facility Modifier None Typical Low $125.89 Median $302.00 Typical High $616.60 | Facility | None | $125.89 | $302.00 | $616.60 |
United Setting Professional Modifier None Typical Low $229.09 Median $758.58 Typical High $2,238.72 | Professional | None | $229.09 | $758.58 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $1,174.90 | Professional | None | $204.17 | $302.00 | $1,174.90 |
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 $107.15 Median $346.74 Typical High $630.96 | Professional | 52 · Reduced service | $107.15 | $346.74 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $138.04 Typical High $257.04 | Professional | 53 · Discontinued | $42.66 | $138.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $512.86 Typical High $954.99 | Professional | 54 · Surgery only | $162.18 | $512.86 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $102.33 Typical High $190.55 | Professional | 55 · Aftercare only | $32.36 | $102.33 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $69.18 Typical High $128.82 | Professional | 56 · Pre-op care only | $21.38 | $69.18 | $128.82 |
Where Washington 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.