How much rates vary
Facilitymedian $1,023 · 10th to 90th $145 to $2,188Professionalmedian $257 · 10th to 90th $78 to $891
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 $53.70 Median $218.78 Typical High $14,454.40 | Facility | None | $53.70 | $218.78 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $218.78 Typical High $1,230.27 | Professional | None | $53.70 | $218.78 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $223.87 Typical High $398.11 | Professional | None | $77.62 | $223.87 | $398.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $338.84 Typical High $588.84 | Professional | 50 · Both sides | $117.49 | $338.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $724.44 Typical High $1,479.11 | Facility | None | $630.96 | $724.44 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $263.03 Typical High $954.99 | Professional | None | $112.20 | $263.03 | $954.99 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $2,630.27 Typical High $5,128.61 | Facility | None | $69.18 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $588.84 | Professional | None | $107.15 | $199.53 | $588.84 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $302.00 Typical High $870.96 | Professional | 50 · Both sides | $162.18 | $302.00 | $870.96 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $912.01 Typical High $1,778.28 | Facility | None | $144.54 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $616.60 Typical High $1,778.28 | Professional | None | $208.93 | $616.60 | $1,778.28 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $138.04 Median $288.40 Typical High $512.86 | Professional | None | $138.04 | $288.40 | $512.86 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $120.23 Typical High $346.74 | Facility | None | $54.95 | $120.23 | $346.74 |
Quartz Setting Professional Modifier None Typical Low $102.33 Median $331.13 Typical High $794.33 | Professional | None | $102.33 | $331.13 | $794.33 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $2,691.53 | Facility | None | $630.96 | $812.83 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $269.15 Typical High $489.78 | Professional | None | $112.20 | $269.15 | $489.78 |
Security Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $891.25 | Professional | None | $208.93 | $208.93 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $1,412.54 | Professional | None | $275.42 | $478.63 | $1,412.54 |
The Alliance Setting Professional Modifier None Typical Low $107.15 Median $537.03 Typical High $1,071.52 | Professional | None | $107.15 | $537.03 | $1,071.52 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $75.86 Median $245.47 Typical High $724.44 | Professional | None | $75.86 | $245.47 | $724.44 |
10 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 Facility Modifier 52 · Reduced service Typical Low $26.92 Median $26.92 Typical High $109.65 | Facility | 52 · Reduced service | $26.92 | $26.92 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $43.65 | Facility | 53 · Discontinued | $10.96 | $10.96 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $40.74 Median $40.74 Typical High $162.18 | Facility | 54 · Surgery only | $40.74 | $40.74 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $32.36 | Facility | 55 · Aftercare only | $8.13 | $8.13 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $21.88 | Facility | 56 · Pre-op care only | $5.37 | $5.37 | $21.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $109.65 Typical High $616.60 | Professional | 52 · Reduced service | $26.92 | $109.65 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $43.65 Typical High $245.47 | Professional | 53 · Discontinued | $10.96 | $43.65 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $162.18 Typical High $912.01 | Professional | 54 · Surgery only | $40.74 | $162.18 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $32.36 Typical High $181.97 | Professional | 55 · Aftercare only | $8.13 | $32.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $21.88 Typical High $123.03 | Professional | 56 · Pre-op care only | $5.37 | $21.88 | $123.03 |
Where Wisconsin sits
The same service costs 12.7 times more in Vermont than in Delaware. 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 $3,748DE $296
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.