How much rates vary
Facilitymedian $1,585 · 10th to 90th $589 to $5,623Professionalmedian $603 · 10th to 90th $407 to $1,122
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 $407.38 Median $4,365.16 Typical High $7,413.10 | Facility | None | $407.38 | $4,365.16 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $1,148.15 | Professional | None | $354.81 | $501.19 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $812.83 Typical High $1,122.02 | Professional | None | $457.09 | $812.83 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,230.27 Typical High $5,754.40 | Facility | None | $575.44 | $1,230.27 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,023.29 | Professional | None | $398.11 | $602.56 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $933.25 Typical High $1,584.89 | Professional | 50 · Both sides | $660.69 | $933.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,318.26 | Professional | None | $478.63 | $707.95 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,023.29 | Professional | None | $467.74 | $645.65 | $1,023.29 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $1,258.93 | Professional | None | $467.74 | $812.83 | $1,258.93 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,348.96 | Professional | None | $436.52 | $630.96 | $1,348.96 |
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 $177.83 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $177.83 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $72.44 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $53.70 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $35.48 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $251.19 | $316.23 | $380.19 |
Where Georgia 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.