How much rates vary
Facilitymedian $1,202 · 10th to 90th $468 to $5,888Professionalmedian $562 · 10th to 90th $257 to $1,380
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $323.59 Median $7,079.46 Typical High $14,125.38 | Facility | None | $323.59 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $912.01 | Professional | None | $190.55 | $363.08 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $112.20 Typical High $281.84 | Professional | 53 · Discontinued | $60.26 | $112.20 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Facility | None | $501.19 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $2,754.23 Typical High $5,888.44 | Facility | None | $363.08 | $2,754.23 | $5,888.44 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $562.34 Typical High $1,548.82 | Professional | None | $229.09 | $562.34 | $1,548.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $128.82 Typical High $281.84 | Professional | 53 · Discontinued | $64.57 | $128.82 | $281.84 |
Premera BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,584.89 | Facility | None | $776.25 | $1,148.15 | $1,584.89 |
Premera BCBS Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,380.38 | Professional | None | $741.31 | $741.31 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,981.07 | Facility | None | $446.68 | $1,096.48 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $794.33 | Professional | None | $257.04 | $302.00 | $794.33 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $2,951.21 | Facility | None | $831.76 | $1,778.28 | $2,951.21 |
United Setting Professional Modifier None Typical Low $194.98 Median $512.86 Typical High $1,412.54 | Professional | None | $194.98 | $512.86 | $1,412.54 |
8 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 $95.50 Median $162.18 Typical High $281.84 | Professional | 52 · Reduced service | $95.50 | $162.18 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $245.47 Typical High $426.58 | Professional | 54 · Surgery only | $144.54 | $245.47 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $48.98 Typical High $85.11 | Professional | 55 · Aftercare only | $28.84 | $48.98 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $32.36 Typical High $56.23 | Professional | 56 · Pre-op care only | $19.05 | $32.36 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $162.18 Typical High $281.84 | Professional | 52 · Reduced service | $102.33 | $162.18 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $245.47 Typical High $426.58 | Professional | 54 · Surgery only | $151.36 | $245.47 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $48.98 Typical High $85.11 | Professional | 55 · Aftercare only | $30.90 | $48.98 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $56.23 | Professional | 56 · Pre-op care only | $20.42 | $32.36 | $56.23 |
Where Alaska sits
The same service costs 5.8 times more in Vermont than in Maine. 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 $4,478ME $766
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.