How much rates vary
Facilitymedian $2,570 · 10th to 90th $513 to $9,550Professionalmedian $537 · 10th to 90th $407 to $813
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 $912.01 Typical High $10,000.00 | Facility | None | $537.03 | $912.01 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $912.01 | Professional | None | $426.58 | $562.34 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $691.83 | Professional | None | $416.87 | $512.86 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $776.25 Typical High $1,047.13 | Professional | 50 · Both sides | $616.60 | $776.25 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $3,162.28 | Professional | None | $398.11 | $446.68 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $3,019.95 | Facility | None | $524.81 | $1,659.59 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $794.33 | Professional | None | $407.38 | $524.81 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $812.83 | Professional | None | $389.05 | $660.69 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | None | $549.54 | $676.08 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $562.34 Typical High $912.01 | Facility | None | $467.74 | $562.34 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Sentara Setting Facility Modifier None Typical Low $354.81 Median $1,445.44 Typical High $8,709.64 | Facility | None | $354.81 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $4,073.80 | Professional | None | $426.58 | $630.96 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $912.01 | Professional | None | $338.84 | $549.54 | $912.01 |
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 $213.80 Median $234.42 Typical High $281.84 | Professional | 52 · Reduced service | $213.80 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $416.87 | Professional | 54 · Surgery only | $323.59 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $56.23 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $389.05 |
Where Virginia 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.