How much rates vary
Facilitymedian $2,570 · 10th to 90th $912 to $5,888Professionalmedian $380 · 10th to 90th $224 to $1,995
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 $1,148.15 Median $2,818.38 Typical High $14,125.38 | Facility | None | $1,148.15 | $2,818.38 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $1,412.54 | Professional | None | $218.78 | $371.54 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $1,148.15 | Professional | None | $91.20 | $181.97 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $524.81 Typical High $2,290.87 | Professional | None | $223.87 | $524.81 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,905.46 Typical High $2,630.27 | Facility | None | $616.60 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $1,513.56 | Professional | None | $223.87 | $323.59 | $1,513.56 |
Hometown Health Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $2,238.72 | Professional | None | $239.88 | $407.38 | $2,238.72 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $2.51 Median $302.00 Typical High $2,691.53 | Professional | None | $2.51 | $302.00 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $1,258.93 Typical High $4,265.80 | Facility | None | $199.53 | $1,258.93 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $6,760.83 | Facility | None | $954.99 | $1,318.26 | $6,760.83 |
United Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $1,862.09 | Professional | None | $234.42 | $407.38 | $1,862.09 |
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 $109.65 Median $169.82 Typical High $707.95 | Professional | 52 · Reduced service | $109.65 | $169.82 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $67.61 Typical High $281.84 | Professional | 53 · Discontinued | $43.65 | $67.61 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $257.04 Typical High $1,071.52 | Professional | 54 · Surgery only | $162.18 | $257.04 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $51.29 Typical High $213.80 | Professional | 55 · Aftercare only | $32.36 | $51.29 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $33.88 Typical High $141.25 | Professional | 56 · Pre-op care only | $21.88 | $33.88 | $141.25 |
Where Nevada 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.