How much rates vary
Facilitymedian $1,995 · 10th to 90th $832 to $12,303Professionalmedian $525 · 10th to 90th $195 to $1,820
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 $281.84 Median $2,511.89 Typical High $11,220.18 | Facility | None | $281.84 | $2,511.89 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $1,513.56 | Professional | None | $204.17 | $316.23 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $1,230.27 | Professional | None | $194.98 | $234.42 | $1,230.27 |
AvMed Setting Facility Modifier None Typical Low $562.34 Median $1,819.70 Typical High $9,772.37 | Facility | None | $562.34 | $1,819.70 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $1,348.96 | Professional | None | $239.88 | $346.74 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $11,481.54 | Facility | None | $512.86 | $2,137.96 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $457.09 Typical High $1,778.28 | Professional | None | $177.83 | $457.09 | $1,778.28 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $1,949.84 Typical High $16,982.44 | Facility | None | $977.24 | $1,949.84 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $251.19 Median $870.96 Typical High $977.24 | Professional | None | $251.19 | $870.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $2,630.27 | Professional | None | $933.25 | $1,348.96 | $2,630.27 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,949.84 Typical High $7,585.78 | Facility | None | $794.33 | $1,949.84 | $7,585.78 |
United Setting Professional Modifier None Typical Low $194.98 Median $407.38 Typical High $1,905.46 | Professional | None | $194.98 | $407.38 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $524.81 Typical High $524.81 | Professional | None | $158.49 | $524.81 | $524.81 |
7 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 $102.33 Median $141.25 Typical High $588.84 | Professional | 52 · Reduced service | $102.33 | $141.25 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $56.23 Typical High $234.42 | Professional | 53 · Discontinued | $40.74 | $56.23 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $208.93 Typical High $891.25 | Professional | 54 · Surgery only | $154.88 | $208.93 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $42.66 Typical High $177.83 | Professional | 55 · Aftercare only | $30.90 | $42.66 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.18 Typical High $117.49 | Professional | 56 · Pre-op care only | $20.42 | $28.18 | $117.49 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $97.72 Typical High $158.49 | Professional | 51 · Multiple procedures | $97.72 | $97.72 | $158.49 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | 53 · Discontinued | $1,122.02 | $1,122.02 | $1,230.27 |
Where Florida 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.