How much rates vary
Facilitymedian $3,802 · 10th to 90th $631 to $8,511Professionalmedian $562 · 10th to 90th $417 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 $630.96 Median $3,388.44 Typical High $9,120.11 | Facility | None | $630.96 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $524.81 | Professional | None | $416.87 | $457.09 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,000.00 | Professional | None | $467.74 | $676.08 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,288.25 Typical High $2,187.76 | Facility | None | $588.84 | $1,288.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $776.25 | Professional | None | $398.11 | $512.86 | $776.25 |
Denver HMP Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $954.99 | Facility | None | $416.87 | $537.03 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $891.25 | Professional | None | $489.78 | $660.69 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $1,445.44 | Facility | None | $512.86 | $954.99 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $645.65 | Professional | None | $416.87 | $512.86 | $645.65 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $870.96 | Professional | None | $398.11 | $524.81 | $870.96 |
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 $208.93 Median $218.78 Typical High $229.09 | Professional | 52 · Reduced service | $208.93 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $83.18 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $331.13 Typical High $346.74 | Professional | 54 · Surgery only | $316.23 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $69.18 | Professional | 55 · Aftercare only | $63.10 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $309.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $295.12 | $309.03 | $323.59 |
Where Colorado sits
The same service costs 4.5 times more in Vermont than in Florida. 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 $4,521FL $1,007
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.