How much rates vary
Facilitymedian $912 · 10th to 90th $389 to $3,715Professionalmedian $316 · 10th to 90th $162 to $1,175
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 $977.24 Median $3,019.95 Typical High $6,760.83 | Facility | None | $977.24 | $3,019.95 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $371.54 | Professional | None | $151.36 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $74.13 Typical High $138.04 | Professional | 53 · Discontinued | $30.20 | $74.13 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $346.74 | Professional | None | $154.88 | $162.18 | $346.74 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Setting Professional Modifier None Typical Low $234.42 Median $457.09 Typical High $562.34 | Professional | None | $234.42 | $457.09 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $512.86 Typical High $2,187.76 | Facility | None | $478.63 | $512.86 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $602.56 Typical High $3,019.95 | Facility | None | $257.04 | $602.56 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,174.90 Typical High $2,187.76 | Professional | None | $323.59 | $1,174.90 | $2,187.76 |
United Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $3,311.31 | Facility | None | $363.08 | $912.01 | $3,311.31 |
United Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $416.87 | Professional | None | $177.83 | $295.12 | $416.87 |
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 $74.13 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $74.13 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $112.20 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $22.39 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.14 | $22.91 | $27.54 |
Where Arizona 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.