How much rates vary
Facilitymedian $2,042 · 10th to 90th $631 to $5,623Professionalmedian $468 · 10th to 90th $204 to $4,898
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 $977.24 Median $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $398.11 Typical High $1,548.82 | Professional | None | $204.17 | $398.11 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $1,174.90 | Professional | None | $199.53 | $288.40 | $1,174.90 |
BCBS Arizona Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Arizona Setting Professional Modifier None Typical Low $239.88 Median $1,096.48 Typical High $2,398.83 | Professional | None | $239.88 | $1,096.48 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $3,548.13 | Facility | None | $831.76 | $1,995.26 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $1,513.56 | Professional | None | $204.17 | $363.08 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $1,737.80 Typical High $9,549.93 | Facility | None | $524.81 | $1,737.80 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $4,897.79 Typical High $9,772.37 | Professional | None | $331.13 | $4,897.79 | $9,772.37 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $1,698.24 | Professional | None | $229.09 | $338.84 | $1,698.24 |
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 $100.00 Median $165.96 Typical High $537.03 | Professional | 52 · Reduced service | $100.00 | $165.96 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $66.07 Typical High $218.78 | Professional | 53 · Discontinued | $40.74 | $66.07 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $251.19 Typical High $812.83 | Professional | 54 · Surgery only | $151.36 | $251.19 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $50.12 Typical High $162.18 | Professional | 55 · Aftercare only | $30.20 | $50.12 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $33.11 Typical High $107.15 | Professional | 56 · Pre-op care only | $20.42 | $33.11 | $107.15 |
Where Arizona 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.