How much rates vary
Facilitymedian $4,786 · 10th to 90th $851 to $11,749Professionalmedian $562 · 10th to 90th $398 to $977
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $758.58 | Professional | None | $398.11 | $524.81 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $9,120.11 Typical High $13,489.63 | Facility | None | $3,162.28 | $9,120.11 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $954.99 | Professional | None | $398.11 | $562.34 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $851.14 Typical High $1,380.38 | Professional | 50 · Both sides | $602.56 | $851.14 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,311.31 Typical High $4,265.80 | Facility | None | $851.14 | $3,311.31 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,148.15 | Professional | None | $524.81 | $630.96 | $1,148.15 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,148.15 | Professional | None | $575.44 | $575.44 | $1,148.15 |
Health New England Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $1,071.52 | Professional | None | $371.54 | $549.54 | $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 $199.53 Median $263.03 Typical High $316.23 | Professional | 52 · Reduced service | $199.53 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $104.71 Typical High $125.89 | Professional | 53 · Discontinued | $79.43 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $398.11 Typical High $467.74 | Professional | 54 · Surgery only | $295.12 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $79.43 Typical High $93.33 | Professional | 55 · Aftercare only | $58.88 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $39.81 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $371.54 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $275.42 | $371.54 | $436.52 |
Where Connecticut 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.