How much rates vary
Facilitymedian $2,399 · 10th to 90th $1,202 to $3,715Professionalmedian $794 · 10th to 90th $646 to $1,549
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 $794.33 Median $1,513.56 Typical High $2,398.83 | Facility | None | $794.33 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,548.82 Typical High $1,548.82 | Professional | None | $812.83 | $1,548.82 | $1,548.82 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
BCBS Alabama Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $1,047.13 Median $1,380.38 Typical High $1,445.44 | Professional | 32 · Mandated service | $1,047.13 | $1,380.38 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $2,041.74 | Facility | None | $645.65 | $1,737.80 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,513.56 | Professional | None | $676.08 | $776.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,096.48 | $2,454.71 | $5,248.07 |
United Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,000.00 | Professional | None | $645.65 | $741.31 | $1,000.00 |
7 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 $562.34 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $562.34 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $223.87 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $831.76 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $165.96 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $112.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $776.25 | $1,071.52 | $1,071.52 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | 50 · Both sides | $3,630.78 | $3,630.78 | $3,630.78 |
Where Alabama sits
The same service costs 3.6 times more in Vermont than in Montana. 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 $8,561MT $2,405
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.