How much rates vary
Facilitymedian $1,950 · 10th to 90th $525 to $6,310Professionalmedian $513 · 10th to 90th $389 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 $398.11 Median $2,511.89 Typical High $7,762.47 | Facility | None | $398.11 | $2,511.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $776.25 | Professional | None | $354.81 | $446.68 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $616.60 | Professional | None | $467.74 | $616.60 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $812.83 | Professional | None | $389.05 | $501.19 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $741.31 Typical High $1,230.27 | Professional | 50 · Both sides | $575.44 | $741.31 | $1,230.27 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $776.25 | Professional | None | $426.58 | $575.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,041.74 Typical High $2,691.53 | Facility | None | $645.65 | $2,041.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $1,071.52 | Professional | None | $416.87 | $537.03 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $26,302.68 | Facility | None | $588.84 | $2,344.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $3,090.30 Typical High $3,801.89 | Professional | None | $457.09 | $3,090.30 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $954.99 | Professional | None | $389.05 | $549.54 | $954.99 |
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 $154.88 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $154.88 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $75.86 Typical High $93.33 | Professional | 53 · Discontinued | $61.66 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $288.40 Typical High $346.74 | Professional | 54 · Surgery only | $229.09 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $57.54 Typical High $69.18 | Professional | 55 · Aftercare only | $45.71 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.90 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $269.15 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $213.80 | $269.15 | $323.59 |
Where Missouri 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.