How much rates vary
Facilitymedian $3,311 · 10th to 90th $851 to $3,311Professionalmedian $933 · 10th to 90th $229 to $1,622
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 $316.23 Median $1,122.02 Typical High $1,862.09 | Facility | None | $316.23 | $1,122.02 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $1,621.81 | Professional | None | $316.23 | $416.87 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $1,023.29 | Professional | None | $169.82 | $223.87 | $1,023.29 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
BCBS Alabama Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,819.70 | Professional | None | $977.24 | $1,348.96 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,659.59 Typical High $2,187.76 | Facility | None | $549.54 | $1,659.59 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $831.76 | Professional | None | $295.12 | $426.58 | $831.76 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $4,168.69 | Facility | None | $831.76 | $2,238.72 | $4,168.69 |
United Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $1,412.54 | Professional | None | $199.53 | $363.08 | $1,412.54 |
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 $154.88 Median $269.15 Typical High $812.83 | Professional | 52 · Reduced service | $154.88 | $269.15 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $107.15 Typical High $323.59 | Professional | 53 · Discontinued | $63.10 | $107.15 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $407.38 Typical High $1,202.26 | Professional | 54 · Surgery only | $234.42 | $407.38 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $81.28 Typical High $239.88 | Professional | 55 · Aftercare only | $46.77 | $81.28 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $53.70 Typical High $162.18 | Professional | 56 · Pre-op care only | $31.62 | $53.70 | $162.18 |
Where Alabama sits
The same service costs 4.3 times more in Vermont than in Maine. 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 $8,043ME $1,891
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.