How much rates vary
Facilitymedian $1,514 · 10th to 90th $275 to $4,571Professionalmedian $263 · 10th to 90th $158 to $389
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 $275.42 Median $2,454.71 Typical High $4,786.30 | Facility | None | $275.42 | $2,454.71 | $4,786.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $91.20 Typical High $165.96 | Facility | 53 · Discontinued | $54.95 | $91.20 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $489.78 | Professional | None | $186.21 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $91.20 Typical High $165.96 | Professional | 53 · Discontinued | $54.95 | $91.20 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $501.19 Typical High $512.86 | Facility | None | $478.63 | $501.19 | $512.86 |
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 $151.36 Median $257.04 Typical High $354.81 | Professional | None | $151.36 | $257.04 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,754.23 | Facility | None | $1,445.44 | $1,862.09 | $2,754.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $389.05 | Professional | None | $177.83 | $316.23 | $389.05 |
Regence BlueShield Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $158.49 Typical High $194.98 | Professional | 53 · Discontinued | $89.13 | $158.49 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $630.96 | Professional | None | $194.98 | $288.40 | $630.96 |
Select Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $144.54 Typical High $316.23 | Professional | 53 · Discontinued | $97.72 | $144.54 | $316.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $120.23 Median $269.15 Typical High $602.56 | Professional | None | $120.23 | $269.15 | $602.56 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $549.54 | Professional | None | $181.97 | $323.59 | $549.54 |
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 $138.04 Typical High $245.47 | Professional | 52 · Reduced service | $95.50 | $138.04 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $204.17 Typical High $363.08 | Professional | 54 · Surgery only | $141.25 | $204.17 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $41.69 Typical High $72.44 | Professional | 55 · Aftercare only | $28.18 | $41.69 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $27.54 Typical High $48.98 | Professional | 56 · Pre-op care only | $19.05 | $27.54 | $48.98 |
Where Utah 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.