How much rates vary
Facilitymedian $1,698 · 10th to 90th $513 to $2,818Professionalmedian $417 · 10th to 90th $214 to $2,188
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 $245.47 Median $389.05 Typical High $1,621.81 | Facility | None | $245.47 | $389.05 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $478.63 Typical High $2,041.74 | Professional | None | $190.55 | $478.63 | $2,041.74 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $323.59 | Professional | None | $223.87 | $245.47 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $2,884.03 | Facility | None | $512.86 | $1,819.70 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $588.84 Typical High $2,398.83 | Professional | None | $213.80 | $588.84 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,584.89 | $2,754.23 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $2,818.38 | Facility | None | $758.58 | $1,412.54 | $2,818.38 |
United Setting Professional Modifier None Typical Low $239.88 Median $501.19 Typical High $2,818.38 | Professional | None | $239.88 | $501.19 | $2,818.38 |
Wellpoint Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,174.90 | $2,137.96 |
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 $95.50 Median $162.18 Typical High $602.56 | Professional | 52 · Reduced service | $95.50 | $162.18 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $64.57 Typical High $239.88 | Professional | 53 · Discontinued | $38.02 | $64.57 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $245.47 Typical High $891.25 | Professional | 54 · Surgery only | $144.54 | $245.47 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $48.98 Typical High $181.97 | Professional | 55 · Aftercare only | $28.84 | $48.98 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $32.36 Typical High $120.23 | Professional | 56 · Pre-op care only | $19.05 | $32.36 | $120.23 |
Where Maryland 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.