How much rates vary
Facilitymedian $871 · 10th to 90th $372 to $3,020Professionalmedian $407 · 10th to 90th $191 to $933
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 $346.74 Median $691.83 Typical High $6,309.57 | Facility | None | $346.74 | $691.83 | $6,309.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $186.21 Typical High $346.74 | Facility | 53 · Discontinued | $69.18 | $186.21 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $630.96 | Professional | None | $186.21 | $338.84 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $77.62 Typical High $213.80 | Professional | 53 · Discontinued | $38.02 | $77.62 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,202.26 | Facility | None | $588.84 | $851.14 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $630.96 | Professional | None | $245.47 | $457.09 | $630.96 |
Cigna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $239.88 Typical High $281.84 | Professional | 53 · Discontinued | $123.03 | $239.88 | $281.84 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $977.24 | Professional | None | $165.96 | $346.74 | $977.24 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $2,570.40 | Facility | None | $371.54 | $776.25 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $630.96 Typical High $2,187.76 | Professional | None | $269.15 | $630.96 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $501.19 Typical High $891.25 | Professional | None | $245.47 | $501.19 | $891.25 |
Midlands Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $123.03 | $251.19 | $281.84 |
Midlands Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,000.00 | Facility | None | $588.84 | $851.14 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $933.25 | Professional | None | $467.74 | $616.60 | $933.25 |
Oscar Health Setting Facility Modifier None Typical Low $489.78 Median $870.96 Typical High $2,454.71 | Facility | None | $489.78 | $870.96 | $2,454.71 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $323.59 Typical High $741.31 | Professional | None | $141.25 | $323.59 | $741.31 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $2,951.21 | Facility | None | $501.19 | $1,778.28 | $2,951.21 |
United Setting Professional Modifier None Typical Low $213.80 Median $426.58 Typical High $794.33 | Professional | None | $213.80 | $426.58 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $933.25 | Professional | None | $363.08 | $416.87 | $933.25 |
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 $85.11 Median $95.50 Typical High $165.96 | Professional | 52 · Reduced service | $85.11 | $95.50 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $263.03 | Professional | 54 · Surgery only | $141.25 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $34.67 Typical High $52.48 | Professional | 55 · Aftercare only | $28.18 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $34.67 |
Where Iowa 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.