How much rates vary
Facilitymedian $18,621 · 10th to 90th $3,090 to $32,359Professionalmedian $1,122 · 10th to 90th $813 to $1,622
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 $1,023.29 Median $1,862.09 Typical High $3,630.78 | Facility | None | $1,023.29 | $1,862.09 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,174.90 | Professional | None | $758.58 | $1,023.29 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,348.96 | $1,348.96 |
BCBS Arkansas Setting Facility Modifier None Typical Low $23,988.33 Median $23,988.33 Typical High $32,359.37 | Facility | None | $23,988.33 | $23,988.33 | $32,359.37 |
BCBS Arkansas Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $16,595.87 Median $18,197.01 Typical High $21,877.62 | Facility | None | $16,595.87 | $18,197.01 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,905.46 | Professional | None | $933.25 | $1,348.96 | $1,905.46 |
Qualchoice Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,548.82 | $1,698.24 |
United Setting Facility Modifier None Typical Low $3,467.37 Median $6,760.83 Typical High $13,489.63 | Facility | None | $3,467.37 | $6,760.83 | $13,489.63 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,659.59 | Professional | None | $741.31 | $1,071.52 | $1,659.59 |
5 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 $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $416.87 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $83.18 | $102.33 | $102.33 |
Where Arkansas sits
The same service costs 13.8 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 $33,708MT $2,434
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.