How much rates vary
Facilitymedian $1,585 · 10th to 90th $708 to $4,467Professionalmedian $479 · 10th to 90th $224 to $2,291
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 $478.63 Median $1,000.00 Typical High $2,398.83 | Facility | None | $478.63 | $1,000.00 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $478.63 Typical High $2,398.83 | Professional | None | $234.42 | $478.63 | $2,398.83 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $1,258.93 | Professional | None | $218.78 | $295.12 | $1,258.93 |
BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
BCBS Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $3,235.94 | Facility | None | $660.69 | $1,659.59 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $1,862.09 | Professional | None | $257.04 | $489.78 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $5,888.44 | Facility | None | $794.33 | $1,513.56 | $5,888.44 |
United Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $1,513.56 | Professional | None | $229.09 | $380.19 | $1,513.56 |
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 $100.00 Median $239.88 Typical High $1,202.26 | Professional | 52 · Reduced service | $100.00 | $239.88 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $97.72 Typical High $478.63 | Professional | 53 · Discontinued | $39.81 | $97.72 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $363.08 Typical High $1,819.70 | Professional | 54 · Surgery only | $147.91 | $363.08 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $72.44 Typical High $363.08 | Professional | 55 · Aftercare only | $29.51 | $72.44 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $47.86 Typical High $239.88 | Professional | 56 · Pre-op care only | $19.95 | $47.86 | $239.88 |
Where Mississippi 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.