How much rates vary
Facilitymedian $1,820 · 10th to 90th $977 to $4,898Professionalmedian $437 · 10th to 90th $309 to $617
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 $436.52 Median $1,380.38 Typical High $2,454.71 | Facility | None | $436.52 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $501.19 | Professional | None | $346.74 | $436.52 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | None | $223.87 | $223.87 | $251.19 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,621.81 Median $3,630.78 Typical High $4,897.79 | Facility | None | $1,621.81 | $3,630.78 | $4,897.79 |
BCBS Arkansas Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | None | $338.84 | $338.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $1,949.84 | Facility | None | $562.34 | $1,513.56 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $741.31 | Professional | None | $251.19 | $457.09 | $741.31 |
Qualchoice Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | None | $257.04 | $257.04 | $295.12 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $4,786.30 | Facility | None | $1,096.48 | $1,513.56 | $4,786.30 |
United Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $645.65 | Professional | None | $302.00 | $354.81 | $645.65 |
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 $218.78 Median $218.78 Typical High $223.87 | Professional | 52 · Reduced service | $218.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $323.59 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $44.67 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $309.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $302.00 | $309.03 | $316.23 |
Where Arkansas sits
The same service costs 7.8 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 $8,433MT $1,087
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.