How much rates vary
Facilitymedian $759 · 10th to 90th $380 to $3,236Professionalmedian $302 · 10th to 90th $200 to $501
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 $218.78 Median $436.52 Typical High $5,011.87 | Facility | None | $218.78 | $436.52 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $407.38 | Professional | None | $173.78 | $257.04 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $109.65 Typical High $199.53 | Professional | 53 · Discontinued | $43.65 | $109.65 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $363.08 | Professional | None | $162.18 | $162.18 | $363.08 |
BCBS Setting Facility Modifier None Typical Low $537.03 Median $812.83 Typical High $3,890.45 | Facility | None | $537.03 | $812.83 | $3,890.45 |
BCBS Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $416.87 | Professional | None | $199.53 | $331.13 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $489.78 Typical High $1,412.54 | Facility | None | $478.63 | $489.78 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $208.93 Typical High $346.74 | Professional | None | $33.11 | $208.93 | $346.74 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $691.83 Typical High $1,513.56 | Facility | None | $251.19 | $691.83 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $676.08 | Professional | None | $302.00 | $302.00 | $676.08 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $2,630.27 | Facility | None | $346.74 | $707.95 | $2,630.27 |
United Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $616.60 | Professional | None | $229.09 | $363.08 | $616.60 |
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 $74.13 Median $109.65 Typical High $199.53 | Professional | 52 · Reduced service | $74.13 | $109.65 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $173.78 Typical High $302.00 | Professional | 54 · Surgery only | $112.20 | $173.78 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $35.48 Typical High $60.26 | Professional | 55 · Aftercare only | $22.39 | $35.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $23.44 Typical High $40.74 | Professional | 56 · Pre-op care only | $14.79 | $23.44 | $40.74 |
Where New Mexico 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.