How much rates vary
Facilitymedian $2,630 · 10th to 90th $776 to $6,918Professionalmedian $776 · 10th to 90th $603 to $7,943
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 $977.24 Median $5,011.87 Typical High $8,317.64 | Facility | None | $977.24 | $5,011.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,047.13 | Professional | None | $707.95 | $831.76 | $1,047.13 |
BCBS Arizona Setting Facility Modifier None Typical Low $776.25 Median $1,862.09 Typical High $4,897.79 | Facility | None | $776.25 | $1,862.09 | $4,897.79 |
BCBS Arizona Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $812.83 | Professional | None | $660.69 | $660.69 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,995.26 Typical High $3,548.13 | Facility | None | $851.14 | $1,995.26 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,023.29 | Professional | None | $588.84 | $776.25 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $8,912.51 | Facility | None | $758.58 | $2,754.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $7,943.28 | Professional | None | $588.84 | $1,047.13 | $7,943.28 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $7,244.36 | Facility | None | $812.83 | $2,951.21 | $7,244.36 |
United Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,096.48 | Professional | None | $575.44 | $707.95 | $1,096.48 |
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 $416.87 Median $416.87 Typical High $446.68 | Professional | 52 · Reduced service | $416.87 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | 53 · Discontinued | $165.96 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $630.96 |
Where Arizona 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.