How much rates vary
Facilitymedian $1,096 · 10th to 90th $355 to $4,365Professionalmedian $302 · 10th to 90th $182 to $447
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 $194.98 Median $2,238.72 Typical High $5,011.87 | Facility | None | $194.98 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $363.08 | Professional | None | $190.55 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $81.28 Typical High $181.97 | Professional | 53 · Discontinued | $38.90 | $81.28 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | None | $162.18 | $162.18 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,548.13 Typical High $4,466.84 | Facility | None | $1,096.48 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $346.74 Typical High $489.78 | Professional | None | $181.97 | $346.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $537.03 Typical High $676.08 | Facility | None | $489.78 | $537.03 | $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 |
Cigna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $107.15 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $181.97 Median $346.74 Typical High $537.03 | Professional | None | $181.97 | $346.74 | $537.03 |
Hometown Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Hometown Health Setting Professional Modifier None Typical Low $2.75 Median $245.47 Typical High $794.33 | Professional | None | $2.75 | $245.47 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $380.19 Typical High $4,265.80 | Facility | None | $162.18 | $380.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $380.19 | Professional | None | $138.04 | $208.93 | $380.19 |
Select Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $104.71 Typical High $186.21 | Professional | 53 · Discontinued | $69.18 | $104.71 | $186.21 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $158.49 Median $316.23 Typical High $467.74 | Professional | None | $158.49 | $316.23 | $467.74 |
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 $95.50 Median $102.33 Typical High $181.97 | Professional | 52 · Reduced service | $95.50 | $102.33 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $269.15 | Professional | 54 · Surgery only | $141.25 | $177.83 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $54.95 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.05 | $23.99 | $36.31 |
Where Nevada 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.