How much rates vary
Facilitymedian $759 · 10th to 90th $295 to $1,288Professionalmedian $295 · 10th to 90th $182 to $501
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 $181.97 Median $912.01 Typical High $1,862.09 | Facility | None | $181.97 | $912.01 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $363.08 | Professional | None | $181.97 | $229.09 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $91.20 Typical High $147.91 | Professional | 53 · Discontinued | $36.31 | $91.20 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $512.86 | Professional | None | $234.42 | $275.42 | $512.86 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $117.49 |
BCBS Arkansas Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $1,148.15 | Facility | None | $478.63 | $851.14 | $1,148.15 |
BCBS Arkansas Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $478.63 | Professional | None | $194.98 | $257.04 | $478.63 |
CareSource Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $426.58 | Professional | None | $40.74 | $52.48 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $478.63 Typical High $758.58 | Facility | None | $436.52 | $478.63 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $302.00 | Professional | None | $218.78 | $302.00 | $302.00 |
Qualchoice Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $588.84 | Professional | None | $269.15 | $316.23 | $588.84 |
Qualchoice Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $1,513.56 | Facility | None | $269.15 | $363.08 | $1,513.56 |
United Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $524.81 | Professional | None | $177.83 | $302.00 | $524.81 |
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 $91.20 Median $107.15 Typical High $147.91 | Professional | 52 · Reduced service | $91.20 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $162.18 Typical High $218.78 | Professional | 54 · Surgery only | $134.90 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $32.36 Typical High $43.65 | Professional | 55 · Aftercare only | $26.92 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $29.51 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 33 · Preventive service | $234.42 | $234.42 | $234.42 |
Qualchoice Setting Professional Modifier 33 · Preventive service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 33 · Preventive service | $269.15 | $269.15 | $269.15 |
Where Arkansas 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.