How much rates vary
Facilitymedian $2,455 · 10th to 90th $240 to $13,804Professionalmedian $603 · 10th to 90th $219 to $1,445
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 $239.88 Median $1,318.26 Typical High $8,912.51 | Facility | None | $239.88 | $1,318.26 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $1,380.38 | Professional | None | $218.78 | $323.59 | $1,380.38 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $1,071.52 Typical High $1,778.28 | Professional | None | $269.15 | $1,071.52 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,862.09 Typical High $4,677.35 | Facility | None | $363.08 | $1,862.09 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $954.99 Typical High $6,165.95 | Professional | None | $288.40 | $954.99 | $6,165.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $10,964.78 Typical High $15,488.17 | Facility | None | $2,818.38 | $10,964.78 | $15,488.17 |
Highmark BCBS Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $9,120.11 | Facility | None | $1,202.26 | $1,479.11 | $9,120.11 |
United Setting Professional Modifier None Typical Low $208.93 Median $407.38 Typical High $1,071.52 | Professional | None | $208.93 | $407.38 | $1,071.52 |
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 $107.15 Median $128.82 Typical High $691.83 | Professional | 52 · Reduced service | $107.15 | $128.82 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $52.48 Typical High $275.42 | Professional | 53 · Discontinued | $43.65 | $52.48 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $194.98 Typical High $1,047.13 | Professional | 54 · Surgery only | $162.18 | $194.98 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.90 Typical High $208.93 | Professional | 55 · Aftercare only | $32.36 | $38.90 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.70 Typical High $138.04 | Professional | 56 · Pre-op care only | $21.88 | $25.70 | $138.04 |
Where West Virginia 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.