How much rates vary
Facilitymedian $501 · 10th to 90th $251 to $1,047Professionalmedian $302 · 10th to 90th $166 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 $109.65 Median $208.93 Typical High $478.63 | Facility | None | $109.65 | $208.93 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $380.19 | Professional | None | $109.65 | $208.93 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $54.95 Typical High $104.71 | Professional | 53 · Discontinued | $21.88 | $54.95 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $154.88 Typical High $288.40 | Professional | 54 · Surgery only | $83.18 | $154.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $30.90 Typical High $57.54 | Professional | 55 · Aftercare only | $16.60 | $30.90 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $20.89 Typical High $38.02 | Professional | 56 · Pre-op care only | $10.96 | $20.89 | $38.02 |
CareFirst Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $501.19 Typical High $758.58 | Facility | None | $446.68 | $501.19 | $758.58 |
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 $323.59 Median $436.52 Typical High $602.56 | Professional | None | $323.59 | $436.52 | $602.56 |
Kaiser Permanente Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $436.52 Typical High $602.56 | Professional | 53 · Discontinued | $323.59 | $436.52 | $602.56 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $169.82 Median $309.03 Typical High $524.81 | Professional | None | $169.82 | $309.03 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $630.96 | Professional | None | $398.11 | $575.44 | $630.96 |
Wellpoint Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $288.40 Typical High $316.23 | Professional | 53 · Discontinued | $199.53 | $288.40 | $316.23 |
1 more rate 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 $54.95 Median $97.72 Typical High $104.71 | Professional | 52 · Reduced service | $54.95 | $97.72 | $104.71 |
Where Maryland 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.