How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,072 to $7,244Professionalmedian $1,288 · 10th to 90th $1,023 to $2,138
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 $831.76 Median $1,288.25 Typical High $2,454.71 | Facility | None | $831.76 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,288.25 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
BCBS Arkansas Setting Facility Modifier None Typical Low $3,019.95 Median $6,309.57 Typical High $8,511.38 | Facility | None | $3,019.95 | $6,309.57 | $8,511.38 |
BCBS Arkansas Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,288.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,862.09 Typical High $2,454.71 | Facility | None | $512.86 | $1,862.09 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,862.09 Typical High $2,187.76 | Professional | None | $977.24 | $1,862.09 | $2,187.76 |
Qualchoice Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $5,754.40 | Facility | None | $1,412.54 | $1,995.26 | $5,754.40 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $2,089.30 | Professional | None | $870.96 | $1,122.02 | $2,089.30 |
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 $501.19 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $199.53 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $741.31 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $691.83 | $891.25 | $891.25 |
Where Arkansas sits
The same service costs 5.3 times more in Vermont than in Hawaii. 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 $13,652HI $2,577
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.