How much rates vary
Facilitymedian $2,399 · 10th to 90th $832 to $5,495Professionalmedian $513 · 10th to 90th $380 to $871
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 $489.78 Median $2,570.40 Typical High $6,165.95 | Facility | None | $489.78 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $645.65 | Professional | None | $398.11 | $489.78 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $891.25 | Professional | None | $416.87 | $588.84 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,737.80 Typical High $2,454.71 | Facility | None | $616.60 | $1,737.80 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $707.95 | Professional | None | $338.84 | $407.38 | $707.95 |
Hometown Health Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $1,995.26 | Professional | None | $398.11 | $562.34 | $1,995.26 |
Hometown Health Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Hometown Health Setting Professional Modifier None Typical Low $3.63 Median $602.56 Typical High $2,511.89 | Professional | None | $3.63 | $602.56 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $4,265.80 | Facility | None | $398.11 | $562.34 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,801.89 | Facility | None | $954.99 | $1,318.26 | $3,801.89 |
United Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $794.33 | Professional | None | $346.74 | $512.86 | $794.33 |
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 $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $79.43 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $295.12 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $354.81 |
Where Nevada 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.