How much rates vary
Facilitymedian $3,548 · 10th to 90th $676 to $5,623Professionalmedian $1,175 · 10th to 90th $257 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 $338.84 Median $3,548.13 Typical High $7,943.28 | Facility | None | $338.84 | $3,548.13 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $467.74 Typical High $1,737.80 | Professional | None | $229.09 | $467.74 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $1,096.48 | Professional | None | $177.83 | $186.21 | $1,096.48 |
BCBS Kansas Setting Facility Modifier None Typical Low $2,089.30 Median $3,801.89 Typical High $3,981.07 | Facility | None | $2,089.30 | $3,801.89 | $3,981.07 |
BCBS Kansas Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,584.89 | Professional | None | $346.74 | $346.74 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,398.83 | Facility | None | $645.65 | $2,089.30 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $660.69 Typical High $2,041.74 | Professional | None | $239.88 | $660.69 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $1,513.56 Typical High $26,302.68 | Facility | None | $467.74 | $1,513.56 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $2,884.03 Typical High $9,772.37 | Professional | None | $346.74 | $2,884.03 | $9,772.37 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $4,677.35 | Facility | None | $831.76 | $1,778.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $1,905.46 | Professional | None | $257.04 | $380.19 | $1,905.46 |
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 $114.82 Median $512.86 Typical High $870.96 | Professional | 52 · Reduced service | $114.82 | $512.86 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $204.17 Typical High $354.81 | Professional | 53 · Discontinued | $45.71 | $204.17 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $758.58 Typical High $1,318.26 | Professional | 54 · Surgery only | $169.82 | $758.58 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $154.88 Typical High $263.03 | Professional | 55 · Aftercare only | $33.88 | $154.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $102.33 Typical High $173.78 | Professional | 56 · Pre-op care only | $22.91 | $102.33 | $173.78 |
Where Kansas 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.