How much rates vary
Facilitymedian $1,585 · 10th to 90th $589 to $5,754Professionalmedian $661 · 10th to 90th $447 to $1,259
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 $4,897.79 Typical High $7,585.78 | Facility | None | $398.11 | $4,897.79 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $1,288.25 | Professional | None | $398.11 | $549.54 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $851.14 Typical High $977.24 | Professional | None | $489.78 | $851.14 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,122.02 | Professional | None | $446.68 | $660.69 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $1,000.00 Typical High $1,737.80 | Professional | 50 · Both sides | $707.95 | $1,000.00 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $416.87 Typical High $724.44 | Professional | 62 · Two surgeons | $302.00 | $416.87 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,445.44 | Professional | None | $524.81 | $794.33 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,122.02 | Professional | None | $512.86 | $724.44 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,412.54 | Professional | None | $524.81 | $891.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,479.11 | Professional | None | $478.63 | $691.83 | $1,479.11 |
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 $245.47 Typical High $295.12 | Professional | 52 · Reduced service | $199.53 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $97.72 Typical High $120.23 | Professional | 53 · Discontinued | $79.43 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $371.54 Typical High $446.68 | Professional | 54 · Surgery only | $295.12 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $74.13 Typical High $89.13 | Professional | 55 · Aftercare only | $58.88 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $48.98 Typical High $60.26 | Professional | 56 · Pre-op care only | $39.81 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $346.74 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $275.42 | $346.74 | $416.87 |
Where Georgia 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.