How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,380 to $11,482Professionalmedian $1,995 · 10th to 90th $1,148 to $2,951
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 $1,479.11 Median $3,235.94 Typical High $6,760.83 | Facility | None | $1,479.11 | $3,235.94 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $1,737.80 | Professional | None | $977.24 | $1,479.11 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,801.89 Typical High $5,128.61 | Facility | None | $954.99 | $3,801.89 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,344.23 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $977.24 Median $1,584.89 Typical High $2,691.53 | Professional | None | $977.24 | $1,584.89 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $3,467.37 Typical High $15,488.17 | Facility | None | $1,380.38 | $3,467.37 | $15,488.17 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,290.87 Typical High $7,762.47 | Professional | None | $1,202.26 | $2,290.87 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,344.23 | $2,884.03 |
Midlands Setting Facility Modifier None Typical Low $2,570.40 Median $3,630.78 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,630.78 | $5,128.61 |
Midlands Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $3,467.37 | Professional | None | $2,041.74 | $2,290.87 | $3,467.37 |
Oscar Health Setting Professional Modifier None Typical Low $977.24 Median $1,819.70 Typical High $2,290.87 | Professional | None | $977.24 | $1,819.70 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,011.87 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,584.89 | $2,884.03 |
Wellmark Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,905.46 | $1,905.46 | $2,238.72 |
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 $489.78 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $489.78 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $194.98 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $724.44 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $97.72 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $676.08 | $1,047.13 | $1,047.13 |
Where Iowa 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.