How much rates vary
Facilitymedian $5,623 · 10th to 90th $977 to $11,482Professionalmedian $692 · 10th to 90th $447 to $1,072
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 $537.03 Median $2,570.40 Typical High $8,912.51 | Facility | None | $537.03 | $2,570.40 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $933.25 | Professional | None | $398.11 | $537.03 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,174.90 | Professional | None | $512.86 | $758.58 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $3,019.95 | Facility | None | $691.83 | $2,238.72 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $933.25 | Professional | None | $436.52 | $630.96 | $933.25 |
Denver HMP Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $831.76 | Facility | None | $426.58 | $575.44 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,023.29 | Professional | None | $446.68 | $676.08 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $1,096.48 Typical High $2,630.27 | Facility | None | $588.84 | $1,096.48 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $588.84 Typical High $1,148.15 | Professional | None | $288.40 | $588.84 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,570.40 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,570.40 | $7,585.78 |
United Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $1,071.52 | Professional | None | $457.09 | $645.65 | $1,071.52 |
6 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 $208.93 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $85.11 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $42.66 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $295.12 | $316.23 | $371.54 |
Where Colorado 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.