How much rates vary
Facilitymedian $1,950 · 10th to 90th $427 to $5,129Professionalmedian $347 · 10th to 90th $174 to $457
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 $186.21 Median $426.58 Typical High $5,011.87 | Facility | None | $186.21 | $426.58 | $5,011.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $125.89 Typical High $269.15 | Facility | 53 · Discontinued | $81.28 | $125.89 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $363.08 | Professional | None | $169.82 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $85.11 Typical High $165.96 | Professional | 53 · Discontinued | $33.88 | $85.11 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $234.42 | Professional | None | $154.88 | $154.88 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $6,165.95 | Facility | None | $630.96 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $436.52 | Professional | None | $295.12 | $354.81 | $436.52 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $151.36 Typical High $177.83 | Professional | 53 · Discontinued | $66.07 | $151.36 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $1,023.29 | Facility | None | $186.21 | $186.21 | $1,023.29 |
CareSource Setting Professional Modifier None Typical Low $38.02 Median $154.88 Typical High $416.87 | Professional | None | $38.02 | $154.88 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $512.86 Typical High $977.24 | Facility | None | $478.63 | $512.86 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,819.70 | Professional | None | $302.00 | $302.00 | $1,819.70 |
Cigna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $186.21 Typical High $426.58 | Professional | 53 · Discontinued | $144.54 | $186.21 | $426.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $489.78 Median $1,096.48 Typical High $2,089.30 | Facility | None | $489.78 | $1,096.48 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $446.68 | Professional | None | $186.21 | $245.47 | $446.68 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $120.23 Typical High $223.87 | Professional | 53 · Discontinued | $93.33 | $120.23 | $223.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,905.46 Typical High $3,801.89 | Facility | None | $398.11 | $1,905.46 | $3,801.89 |
United Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $512.86 | Professional | None | $177.83 | $302.00 | $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 $85.11 Median $112.20 Typical High $173.78 | Professional | 52 · Reduced service | $85.11 | $112.20 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $177.83 Typical High $263.03 | Professional | 54 · Surgery only | $128.82 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $35.48 Typical High $52.48 | Professional | 55 · Aftercare only | $25.70 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.44 Typical High $34.67 | Professional | 56 · Pre-op care only | $16.98 | $23.44 | $34.67 |
Where Indiana 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.