How much rates vary
Facilitymedian $1,413 · 10th to 90th $417 to $1,413Professionalmedian $302 · 10th to 90th $117 to $468
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 $229.09 Median $645.65 Typical High $1,862.09 | Facility | None | $229.09 | $645.65 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $416.87 | Professional | None | $229.09 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $83.18 Typical High $114.82 | Professional | 53 · Discontinued | $45.71 | $83.18 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
BCBS Alabama Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $478.63 | Professional | None | $87.10 | $154.88 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $467.74 Typical High $630.96 | Facility | None | $436.52 | $467.74 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $512.86 | Professional | None | $154.88 | $281.84 | $512.86 |
4 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 $112.20 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $112.20 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $309.03 | Professional | 54 · Surgery only | $173.78 | $173.78 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $61.66 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $41.69 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $41.69 |
Where Alabama 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.