How much rates vary
Facilitymedian $525 · 10th to 90th $316 to $1,514Professionalmedian $302 · 10th to 90th $155 to $741
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 $151.36 Median $741.31 Typical High $1,819.70 | Facility | None | $151.36 | $741.31 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $380.19 | Professional | None | $138.04 | $223.87 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $63.10 Typical High $107.15 | Professional | 53 · Discontinued | $30.20 | $63.10 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $288.40 | Professional | 54 · Surgery only | $104.71 | $162.18 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $57.54 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.38 Typical High $38.02 | Professional | 56 · Pre-op care only | $13.80 | $21.38 | $38.02 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $478.63 | Professional | None | $154.88 | $194.98 | $478.63 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $77.62 | $77.62 | $77.62 |
BCBS Mississippi Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $575.44 | Facility | None | $524.81 | $524.81 | $575.44 |
BCBS Mississippi Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $467.74 Typical High $891.25 | Facility | None | $436.52 | $467.74 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $758.58 | Professional | None | $302.00 | $302.00 | $758.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $302.00 Median $616.60 Typical High $1,819.70 | Facility | None | $302.00 | $616.60 | $1,819.70 |
United Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $691.83 | Professional | None | $177.83 | $309.03 | $691.83 |
2 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 $69.18 Median $107.15 Typical High $112.20 | Professional | 52 · Reduced service | $69.18 | $107.15 | $112.20 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 33 · Preventive service | $218.78 | $218.78 | $218.78 |
Where Mississippi 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.