How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,259 to $10,233Professionalmedian $724 · 10th to 90th $120 to $1,122
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 $933.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $933.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,122.02 | Professional | None | $870.96 | $933.25 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $851.14 | Professional | None | $426.58 | $602.56 | $851.14 |
BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $7,943.28 | Facility | None | $1,584.89 | $2,137.96 | $7,943.28 |
BCBS Setting Professional Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,288.25 | Professional | None | $602.56 | $1,071.52 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $2,454.71 | Facility | None | $630.96 | $1,513.56 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,348.96 | Professional | None | $870.96 | $1,000.00 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,187.76 | Facility | None | $912.01 | $1,258.93 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $2,238.72 | Professional | None | $851.14 | $891.25 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $537.03 Typical High $1,023.29 | Professional | None | $102.33 | $537.03 | $1,023.29 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,659.59 | Professional | None | $691.83 | $891.25 | $1,659.59 |
8 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 $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,584.89 Typical High $3,388.44 | Professional | 50 · Both sides | $1,348.96 | $1,584.89 | $3,388.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $524.81 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $446.68 | $524.81 | $1,122.02 |
Where South Carolina sits
The same service costs 4.1 times more in Vermont than in Maryland. 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 $8,533MD $2,077
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.