How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,202 to $10,000Professionalmedian $1,479 · 10th to 90th $1,000 to $1,738
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 $537.03 Median $1,548.82 Typical High $3,548.13 | Facility | None | $537.03 | $1,548.82 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,548.82 | $1,698.24 |
BCBS Louisiana Setting Facility Modifier None Typical Low $3,162.28 Median $5,011.87 Typical High $11,220.18 | Facility | None | $3,162.28 | $5,011.87 | $11,220.18 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,737.80 | $1,737.80 |
Christus Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $831.76 Typical High $3,467.37 | Facility | None | $501.19 | $831.76 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,230.27 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,019.95 Typical High $10,471.29 | Facility | None | $1,202.26 | $3,019.95 | $10,471.29 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,949.84 | Professional | None | $912.01 | $1,148.15 | $1,949.84 |
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 $676.08 Median $776.25 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $309.03 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $154.88 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,174.90 |
Where Louisiana 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.