How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,000 to $11,482Professionalmedian $759 · 10th to 90th $501 to $1,175
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 $588.84 Median $3,090.30 Typical High $8,912.51 | Facility | None | $588.84 | $3,090.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $1,071.52 | Professional | None | $446.68 | $588.84 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,288.25 | Professional | None | $562.34 | $831.76 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $3,019.95 | Facility | None | $691.83 | $2,238.72 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,023.29 | Professional | None | $489.78 | $691.83 | $1,023.29 |
Denver HMP Setting Facility Modifier None Typical Low $467.74 Median $630.96 Typical High $912.01 | Facility | None | $467.74 | $630.96 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,148.15 | Professional | None | $489.78 | $741.31 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $2,630.27 | Facility | None | $645.65 | $1,202.26 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $645.65 Typical High $1,258.93 | Professional | None | $316.23 | $645.65 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,570.40 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,570.40 | $7,585.78 |
United Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,174.90 | Professional | None | $501.19 | $707.95 | $1,174.90 |
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 $234.42 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $234.42 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $93.33 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $354.81 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $407.38 |
Where Colorado sits
The same service costs 4.7 times more in Vermont than in Montana. 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 $7,643MT $1,633
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.