How much rates vary
Facilitymedian $4,898 · 10th to 90th $851 to $11,749Professionalmedian $631 · 10th to 90th $447 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 $4,570.88 Median $6,760.83 Typical High $10,471.29 | Facility | None | $4,570.88 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $776.25 | Professional | None | $436.52 | $588.84 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $9,120.11 Typical High $13,489.63 | Facility | None | $3,162.28 | $9,120.11 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,071.52 | Professional | None | $446.68 | $630.96 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $933.25 Typical High $1,548.82 | Professional | 50 · Both sides | $660.69 | $933.25 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $398.11 Typical High $645.65 | Professional | 62 · Two surgeons | $281.84 | $398.11 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,311.31 Typical High $4,265.80 | Facility | None | $851.14 | $3,311.31 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,288.25 | Professional | None | $562.34 | $691.83 | $1,288.25 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $3,162.28 | Facility | None | $512.86 | $707.95 | $3,162.28 |
ConnectiCare Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,288.25 | Professional | None | $645.65 | $645.65 | $1,288.25 |
Health New England Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,888.44 | Facility | None | $4,265.80 | $4,265.80 | $5,888.44 |
Health New England Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | None | $660.69 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $1,174.90 | Professional | None | $407.38 | $616.60 | $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 $218.78 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $218.78 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $87.10 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $331.13 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $66.07 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $43.65 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $309.03 | $407.38 | $489.78 |
Where Connecticut 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.