How much rates vary
Facilitymedian $1,072 · 10th to 90th $380 to $2,884Professionalmedian $398 · 10th to 90th $186 to $2,188
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 $234.42 Median $2,511.89 Typical High $7,943.28 | Facility | None | $234.42 | $2,511.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $380.19 | Professional | None | $151.36 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $67.61 Typical High $128.82 | Professional | 53 · Discontinued | $30.20 | $67.61 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $363.08 | Professional | None | $158.49 | $199.53 | $363.08 |
BCBS Kansas Setting Facility Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,148.15 | Facility | None | $616.60 | $1,071.52 | $1,148.15 |
BCBS Kansas Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Professional | None | $436.52 | $436.52 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $676.08 | Facility | None | $478.63 | $602.56 | $676.08 |
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 $275.42 Median $645.65 Typical High $16,218.10 | Facility | None | $275.42 | $645.65 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $1,174.90 Typical High $2,187.76 | Professional | None | $389.05 | $1,174.90 | $2,187.76 |
United Setting Facility Modifier None Typical Low $331.13 Median $691.83 Typical High $2,454.71 | Facility | None | $331.13 | $691.83 | $2,454.71 |
United Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $489.78 | Professional | None | $223.87 | $338.84 | $489.78 |
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 $75.86 Median $85.11 Typical High $138.04 | Professional | 52 · Reduced service | $75.86 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $114.82 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $22.91 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.14 | $23.44 | $33.88 |
Where Kansas 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.