How much rates vary
Facilitymedian $3,311 · 10th to 90th $603 to $8,318Professionalmedian $389 · 10th to 90th $209 to $1,950
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 $223.87 Median $1,288.25 Typical High $5,011.87 | Facility | None | $223.87 | $1,288.25 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $1,548.82 | Professional | None | $223.87 | $363.08 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $1,659.59 | Professional | None | $199.53 | $245.47 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $5,248.07 Typical High $9,772.37 | Facility | None | $933.25 | $5,248.07 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $467.74 Typical High $2,137.96 | Professional | None | $190.55 | $467.74 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $117.49 Median $275.42 Typical High $1,348.96 | Professional | 62 · Two surgeons | $117.49 | $275.42 | $1,348.96 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $3,467.37 | Facility | None | $234.42 | $234.42 | $3,467.37 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,288.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,570.40 Typical High $3,801.89 | Facility | None | $630.96 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $1,737.80 | Professional | None | $245.47 | $380.19 | $1,737.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $616.60 Median $3,548.13 Typical High $4,570.88 | Facility | None | $616.60 | $3,548.13 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $234.42 Median $537.03 Typical High $2,089.30 | Professional | None | $234.42 | $537.03 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,548.13 | $7,943.28 |
United Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $2,137.96 | Professional | None | $245.47 | $389.05 | $2,137.96 |
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 $112.20 Median $251.19 Typical High $660.69 | Professional | 52 · Reduced service | $112.20 | $251.19 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $100.00 Typical High $263.03 | Professional | 53 · Discontinued | $44.67 | $100.00 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $380.19 Typical High $977.24 | Professional | 54 · Surgery only | $169.82 | $380.19 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $75.86 Typical High $199.53 | Professional | 55 · Aftercare only | $33.88 | $75.86 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $50.12 Typical High $131.83 | Professional | 56 · Pre-op care only | $22.39 | $50.12 | $131.83 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $114.82 Typical High $141.25 | Professional | 51 · Multiple procedures | $114.82 | $114.82 | $141.25 |
Where Indiana 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.