How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,514 to $7,943Professionalmedian $1,479 · 10th to 90th $1,072 to $7,762
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 $1,819.70 Median $3,630.78 Typical High $7,943.28 | Facility | None | $1,819.70 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,318.26 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
BCBS Kansas Setting Facility Modifier None Typical Low $3,548.13 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,548.13 | $3,801.89 | $3,801.89 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,090.30 Typical High $3,981.07 | Facility | None | $524.81 | $3,090.30 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,548.82 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $2,951.21 Typical High $16,218.10 | Facility | None | $1,148.15 | $2,951.21 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $7,762.47 | Professional | None | $1,122.02 | $1,348.96 | $7,762.47 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,691.53 Typical High $8,709.64 | Facility | None | $870.96 | $2,691.53 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,258.93 | $1,737.80 |
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 $524.81 Median $660.69 Typical High $851.14 | Professional | 52 · Reduced service | $524.81 | $660.69 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $263.03 Typical High $338.84 | Professional | 53 · Discontinued | $208.93 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $977.24 Typical High $1,258.93 | Professional | 54 · Surgery only | $776.25 | $977.24 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $194.98 Typical High $251.19 | Professional | 55 · Aftercare only | $158.49 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $131.83 Typical High $169.82 | Professional | 56 · Pre-op care only | $104.71 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $912.01 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $724.44 | $912.01 | $1,174.90 |
Where Kansas 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.