How much rates vary
Facilitymedian $1,738 · 10th to 90th $851 to $6,457Professionalmedian $977 · 10th to 90th $724 to $1,950
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 $1,047.13 Typical High $1,995.26 | Facility | None | $776.25 | $1,047.13 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,862.09 Typical High $1,949.84 | Professional | None | $741.31 | $1,862.09 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
BCBS Mississippi Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
BCBS Mississippi Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,659.59 Typical High $3,311.31 | Facility | None | $794.33 | $1,659.59 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,122.02 | Professional | None | $602.56 | $977.24 | $1,122.02 |
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 $977.24 Median $1,737.80 Typical High $7,244.36 | Facility | None | $977.24 | $1,737.80 | $7,244.36 |
United Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,584.89 | Professional | None | $660.69 | $831.76 | $1,584.89 |
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 $371.54 Median $933.25 Typical High $977.24 | Professional | 52 · Reduced service | $371.54 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $371.54 Typical High $389.05 | Professional | 53 · Discontinued | $151.36 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $1,412.54 Typical High $1,479.11 | Professional | 54 · Surgery only | $562.34 | $1,412.54 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $281.84 Typical High $295.12 | Professional | 55 · Aftercare only | $112.20 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $186.21 Typical High $194.98 | Professional | 56 · Pre-op care only | $74.13 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $1,318.26 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $524.81 | $1,318.26 | $1,380.38 |
Where Mississippi 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.