How much rates vary
Facilitymedian $2,692 · 10th to 90th $537 to $9,550Professionalmedian $589 · 10th to 90th $447 to $891
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 $1,096.48 Typical High $10,000.00 | Facility | None | $588.84 | $1,096.48 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,000.00 | Professional | None | $467.74 | $616.60 | $1,000.00 |
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 $457.09 Median $575.44 Typical High $758.58 | Professional | None | $457.09 | $575.44 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $851.14 Typical High $1,148.15 | Professional | 50 · Both sides | $676.08 | $851.14 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $363.08 Typical High $478.63 | Professional | 62 · Two surgeons | $288.40 | $363.08 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $3,890.45 | Professional | None | $436.52 | $489.78 | $3,890.45 |
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 $446.68 Median $575.44 Typical High $870.96 | Professional | None | $446.68 | $575.44 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $912.01 | Professional | None | $436.52 | $741.31 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $741.31 | Professional | None | $588.84 | $741.31 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $616.60 Typical High $1,000.00 | Facility | None | $512.86 | $616.60 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $380.19 Median $1,698.24 Typical High $8,709.64 | Facility | None | $380.19 | $1,698.24 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $4,570.88 | Professional | None | $467.74 | $707.95 | $4,570.88 |
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 $380.19 Median $602.56 Typical High $1,000.00 | Professional | None | $380.19 | $602.56 | $1,000.00 |
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 $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $234.42 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $93.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $467.74 | Professional | 54 · Surgery only | $354.81 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $46.77 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $436.52 |
Where Virginia 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.