How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,023 to $12,023Professionalmedian $603 · 10th to 90th $98 to $955
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 $776.25 Median $5,888.44 Typical High $12,022.64 | Facility | None | $776.25 | $5,888.44 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $954.99 | Professional | None | $602.56 | $630.96 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $9,772.37 | Facility | None | $630.96 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $758.58 | Professional | None | $537.03 | $707.95 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,311.31 | Facility | None | $616.60 | $2,041.74 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $1,174.90 | Professional | None | $562.34 | $588.84 | $1,174.90 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $812.83 | Professional | None | $323.59 | $524.81 | $812.83 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $457.09 Typical High $891.25 | Professional | None | $67.61 | $457.09 | $891.25 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $1,148.15 | Professional | None | $457.09 | $645.65 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $758.58 | Professional | None | $549.54 | $758.58 | $758.58 |
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 $295.12 Median $309.03 Typical High $436.52 | Professional | 52 · Reduced service | $295.12 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $177.83 | Professional | 53 · Discontinued | $120.23 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $660.69 | Professional | 54 · Surgery only | $446.68 | $467.74 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $131.83 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $616.60 |
Where Florida 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.