How much rates vary
Facilitymedian $955 · 10th to 90th $490 to $4,467Professionalmedian $331 · 10th to 90th $166 to $813
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 $363.08 Median $691.83 Typical High $10,964.78 | Facility | None | $363.08 | $691.83 | $10,964.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $186.21 Typical High $346.74 | Facility | 53 · Discontinued | $61.66 | $186.21 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $758.58 | Professional | None | $165.96 | $309.03 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $102.33 Typical High $346.74 | Professional | 53 · Discontinued | $33.88 | $102.33 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $380.19 | Professional | None | $151.36 | $181.97 | $380.19 |
BCBS Nebraska Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $7,413.10 | Facility | None | $602.56 | $3,467.37 | $7,413.10 |
BCBS Nebraska Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $371.54 | Professional | None | $151.36 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $1,023.29 | Facility | None | $575.44 | $794.33 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $467.74 Typical High $812.83 | Professional | None | $218.78 | $467.74 | $812.83 |
Cigna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $234.42 Typical High $407.38 | Professional | 53 · Discontinued | $109.65 | $234.42 | $407.38 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $1,071.52 Typical High $2,754.23 | Facility | None | $478.63 | $1,071.52 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $2,187.76 | Professional | None | $467.74 | $812.83 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $933.25 | Professional | None | $295.12 | $501.19 | $933.25 |
Midlands Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $251.19 Typical High $467.74 | Professional | 53 · Discontinued | $147.91 | $251.19 | $467.74 |
Midlands Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $1,023.29 | Facility | None | $588.84 | $812.83 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $588.84 Typical High $933.25 | Professional | None | $251.19 | $588.84 | $933.25 |
Midlands Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $295.12 Typical High $467.74 | Professional | 53 · Discontinued | $125.89 | $295.12 | $467.74 |
Oscar Health Setting Facility Modifier None Typical Low $676.08 Median $1,479.11 Typical High $1,737.80 | Facility | None | $676.08 | $1,479.11 | $1,737.80 |
United Setting Facility Modifier None Typical Low $467.74 Median $851.14 Typical High $2,754.23 | Facility | None | $467.74 | $851.14 | $2,754.23 |
United Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $812.83 | Professional | None | $263.03 | $467.74 | $812.83 |
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 $83.18 Median $102.33 Typical High $154.88 | Professional | 52 · Reduced service | $83.18 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $154.88 Typical High $234.42 | Professional | 54 · Surgery only | $125.89 | $154.88 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.90 Typical High $46.77 | Professional | 55 · Aftercare only | $25.12 | $30.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $30.90 |
Where Nebraska 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.