How much rates vary
Facilitymedian $631 · 10th to 90th $398 to $3,548Professionalmedian $339 · 10th to 90th $191 to $661
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 $165.96 Median $3,388.44 Typical High $7,413.10 | Facility | None | $165.96 | $3,388.44 | $7,413.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $83.18 Typical High $154.88 | Facility | 53 · Discontinued | $33.11 | $83.18 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $316.23 Typical High $831.76 | Professional | None | $165.96 | $316.23 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $83.18 Typical High $257.04 | Professional | 53 · Discontinued | $33.11 | $83.18 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $323.59 | Professional | None | $169.82 | $295.12 | $323.59 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $251.19 | Professional | 53 · Discontinued | $162.18 | $162.18 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $645.65 | Professional | None | $223.87 | $354.81 | $645.65 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $169.82 Typical High $354.81 | Professional | 53 · Discontinued | $109.65 | $169.82 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $39.81 Median $169.82 Typical High $478.63 | Professional | None | $39.81 | $169.82 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $512.86 Typical High $891.25 | Facility | None | $457.09 | $512.86 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $389.05 Typical High $954.99 | Professional | None | $162.18 | $389.05 | $954.99 |
Kaiser Permanente Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $177.83 Typical High $229.09 | Professional | 53 · Discontinued | $81.28 | $177.83 | $229.09 |
Oscar Health Setting Facility Modifier None Typical Low $724.44 Median $2,089.30 Typical High $2,884.03 | Facility | None | $724.44 | $2,089.30 | $2,884.03 |
Oscar Health Setting Professional Modifier None Typical Low $120.23 Median $239.88 Typical High $645.65 | Professional | None | $120.23 | $239.88 | $645.65 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $194.98 Median $380.19 Typical High $831.76 | Professional | None | $194.98 | $380.19 | $831.76 |
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 $83.18 Median $89.13 Typical High $154.88 | Professional | 52 · Reduced service | $83.18 | $89.13 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $245.47 | Professional | 54 · Surgery only | $123.03 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $34.67 Typical High $48.98 | Professional | 55 · Aftercare only | $24.55 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.91 Typical High $32.36 | Professional | 56 · Pre-op care only | $16.60 | $22.91 | $32.36 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 33 · Preventive service | $186.21 | $186.21 | $186.21 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 51 · Multiple procedures | $501.19 | $501.19 | $501.19 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 59 · Distinct service | $295.12 | $295.12 | $295.12 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $223.87 Median $323.59 Typical High $323.59 | Professional | KX · Policy requirements met | $223.87 | $323.59 | $323.59 |
Where Georgia 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.