How much rates vary
Facilitymedian $1,698 · 10th to 90th $676 to $8,710Professionalmedian $479 · 10th to 90th $347 to $1,549
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 $457.09 Median $6,456.54 Typical High $15,848.93 | Facility | None | $457.09 | $6,456.54 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $831.76 | Professional | None | $354.81 | $446.68 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $1,445.44 | Professional | None | $416.87 | $501.19 | $1,445.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $7,585.78 | Facility | None | $100.00 | $1,737.80 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $977.24 | Professional | None | $257.04 | $398.11 | $977.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $776.25 | Professional | None | $295.12 | $524.81 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,454.71 Typical High $4,786.30 | Facility | None | $645.65 | $2,454.71 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $954.99 | Professional | None | $380.19 | $489.78 | $954.99 |
Contra Costa Health Setting Professional Modifier None Typical Low $208.93 Median $562.34 Typical High $776.25 | Professional | None | $208.93 | $562.34 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $1,318.26 | Professional | None | $416.87 | $630.96 | $1,318.26 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,011.87 | Professional | None | $3,715.35 | $3,715.35 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $741.31 | Professional | None | $446.68 | $446.68 | $741.31 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $2,344.23 Typical High $5,495.41 | Facility | None | $524.81 | $2,344.23 | $5,495.41 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $1,023.29 | Professional | None | $380.19 | $478.63 | $1,023.29 |
Sutter Health Plus Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,348.96 | $1,621.81 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,071.52 Typical High $5,754.40 | Facility | None | $676.08 | $1,071.52 | $5,754.40 |
United Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $1,288.25 | Professional | None | $331.13 | $489.78 | $1,288.25 |
13 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 Facility Modifier 52 · Reduced service Typical Low $177.83 Median $186.21 Typical High $229.09 | Facility | 52 · Reduced service | $177.83 | $186.21 | $229.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $74.13 Typical High $91.20 | Facility | 53 · Discontinued | $70.79 | $74.13 | $91.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $338.84 | Facility | 54 · Surgery only | $269.15 | $281.84 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $67.61 | Facility | 55 · Aftercare only | $53.70 | $56.23 | $67.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $37.15 Typical High $45.71 | Facility | 56 · Pre-op care only | $35.48 | $37.15 | $45.71 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $263.03 Typical High $316.23 | Facility | 78 · Unplanned return to OR | $251.19 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $186.21 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $251.19 | $263.03 | $316.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $741.31 Typical High $1,096.48 | Professional | 50 · Both sides | $575.44 | $741.31 | $1,096.48 |
Where California sits
The same service costs 7.2 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 $9,370ME $1,294
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.