How much rates vary
Facilitymedian $3,090 · 10th to 90th $562 to $10,471Professionalmedian $933 · 10th to 90th $355 to $3,890
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 $457.09 Median $3,019.95 Typical High $6,606.93 | Facility | None | $457.09 | $3,019.95 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $512.86 Typical High $3,019.95 | Professional | None | $239.88 | $512.86 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $3,388.44 | Facility | None | $1,096.48 | $2,691.53 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $3,715.35 | Professional | None | $457.09 | $724.44 | $3,715.35 |
Hally Health Setting Professional Modifier None Typical Low $213.80 Median $524.81 Typical High $1,995.26 | Professional | None | $213.80 | $524.81 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $2,454.71 Typical High $7,079.46 | Facility | None | $501.19 | $2,454.71 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $1,949.84 Typical High $4,897.79 | Professional | None | $501.19 | $1,949.84 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $977.24 Typical High $3,715.35 | Professional | None | $457.09 | $977.24 | $3,715.35 |
Midlands Setting Facility Modifier None Typical Low $1,584.89 Median $2,630.27 Typical High $3,388.44 | Facility | None | $1,584.89 | $2,630.27 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $4,265.80 | Professional | None | $524.81 | $741.31 | $4,265.80 |
Oscar Health Setting Facility Modifier None Typical Low $3,090.30 Median $10,471.29 Typical High $29,512.09 | Facility | None | $3,090.30 | $10,471.29 | $29,512.09 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $269.15 Median $691.83 Typical High $3,235.94 | Professional | None | $269.15 | $691.83 | $3,235.94 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $3,019.95 | Professional | None | $407.38 | $478.63 | $3,019.95 |
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 $128.82 Median $186.21 Typical High $758.58 | Professional | 52 · Reduced service | $128.82 | $186.21 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $74.13 Typical High $302.00 | Professional | 53 · Discontinued | $51.29 | $74.13 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $275.42 Typical High $1,148.15 | Professional | 54 · Surgery only | $194.98 | $275.42 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $54.95 Typical High $229.09 | Professional | 55 · Aftercare only | $38.90 | $54.95 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $37.15 Typical High $151.36 | Professional | 56 · Pre-op care only | $25.70 | $37.15 | $151.36 |
Where Iowa 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.