How much rates vary
Facilitymedian $2,344 · 10th to 90th $955 to $4,898Professionalmedian $813 · 10th to 90th $603 to $5,888
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 $912.01 Median $3,467.37 Typical High $7,943.28 | Facility | None | $912.01 | $3,467.37 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $977.24 | Professional | None | $602.56 | $758.58 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $891.25 | Professional | None | $588.84 | $588.84 | $891.25 |
BCBS Kansas Setting Facility Modifier None Typical Low $1,148.15 Median $2,344.23 Typical High $2,454.71 | Facility | None | $1,148.15 | $2,344.23 | $2,454.71 |
BCBS Kansas Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,258.93 Typical High $1,318.26 | Facility | None | $562.34 | $1,258.93 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $912.01 | Professional | None | $602.56 | $831.76 | $912.01 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $16,218.10 | Facility | None | $794.33 | $1,778.28 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $5,888.44 | Professional | None | $602.56 | $741.31 | $5,888.44 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $4,570.88 | Facility | None | $831.76 | $1,737.80 | $4,570.88 |
United Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $954.99 | Professional | None | $575.44 | $707.95 | $954.99 |
6 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 $302.00 Median $380.19 Typical High $489.78 | Professional | 52 · Reduced service | $302.00 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $151.36 Typical High $194.98 | Professional | 53 · Discontinued | $120.23 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $575.44 Typical High $741.31 | Professional | 54 · Surgery only | $457.09 | $575.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $114.82 Typical High $147.91 | Professional | 55 · Aftercare only | $91.20 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $75.86 Typical High $97.72 | Professional | 56 · Pre-op care only | $60.26 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $537.03 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $426.58 | $537.03 | $691.83 |
Where Kansas sits
The same service costs 4.8 times more in Vermont than in Maryland. 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 $8,399MD $1,739
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.