How much rates vary
Facilitymedian $2,138 · 10th to 90th $759 to $6,310Professionalmedian $1,738 · 10th to 90th $955 to $3,020
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 $616.60 Median $954.99 Typical High $1,995.26 | Facility | None | $616.60 | $954.99 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $2,454.71 Typical High $3,019.95 | Professional | None | $954.99 | $2,454.71 | $3,019.95 |
BCBS Mississippi Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
BCBS Mississippi Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,041.74 Typical High $4,168.69 | Facility | None | $630.96 | $2,041.74 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,621.81 Typical High $1,819.70 | Professional | None | $776.25 | $1,621.81 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,511.89 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,511.89 | $7,244.36 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $2,238.72 | Professional | None | $954.99 | $1,096.48 | $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 $478.63 Median $1,230.27 Typical High $1,513.56 | Professional | 52 · Reduced service | $478.63 | $1,230.27 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $501.19 Typical High $616.60 | Professional | 53 · Discontinued | $190.55 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,862.09 Typical High $2,290.87 | Professional | 54 · Surgery only | $724.44 | $1,862.09 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $371.54 Typical High $457.09 | Professional | 55 · Aftercare only | $144.54 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $245.47 Typical High $302.00 | Professional | 56 · Pre-op care only | $95.50 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,737.80 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $676.08 | $1,737.80 | $2,137.96 |
Where Mississippi 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.