How much rates vary
Facilitymedian $2,754 · 10th to 90th $851 to $7,413Professionalmedian $1,514 · 10th to 90th $977 to $2,512
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 $1,122.02 Median $6,309.57 Typical High $10,000.00 | Facility | None | $1,122.02 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,122.02 | $1,122.02 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $7,244.36 | Facility | None | $776.25 | $1,479.11 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,454.71 | Professional | None | $933.25 | $1,513.56 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,344.23 Typical High $3,890.45 | Professional | 50 · Both sides | $1,659.59 | $2,344.23 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $977.24 Typical High $1,621.81 | Professional | 62 · Two surgeons | $691.83 | $977.24 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $263.03 Typical High $407.38 | Professional | 80 · Assistant surgeon | $169.82 | $263.03 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $229.09 Typical High $363.08 | Professional | AS · PA/NP assist | $151.36 | $229.09 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $3,630.78 Typical High $4,677.35 | Facility | None | $1,122.02 | $3,630.78 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,778.28 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,230.27 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,621.81 | $2,754.23 |
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 $562.34 Median $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $870.96 |
Where Georgia sits
The same service costs 6.7 times more in Vermont than in Kentucky. 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 $18,681KY $2,795
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.