How much rates vary
Facilitymedian $3,548 · 10th to 90th $631 to $7,079Professionalmedian $646 · 10th to 90th $380 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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $630.96 | Professional | None | $416.87 | $588.84 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $28,183.83 | Facility | None | $3,548.13 | $4,168.69 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $977.24 | Professional | None | $380.19 | $724.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $1,096.48 Typical High $1,445.44 | Professional | 50 · Both sides | $575.44 | $1,096.48 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,862.09 Typical High $2,398.83 | Facility | None | $741.31 | $1,862.09 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,023.29 | Professional | None | $549.54 | $630.96 | $1,023.29 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $758.58 | Facility | None | $331.13 | $457.09 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $741.31 | Professional | None | $602.56 | $630.96 | $741.31 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $309.03 Median $602.56 Typical High $1,202.26 | Professional | None | $309.03 | $602.56 | $1,202.26 |
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 $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $208.93 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $85.11 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $446.68 Typical High $478.63 | Professional | 54 · Surgery only | $316.23 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $63.10 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $42.66 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $416.87 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $295.12 | $416.87 | $446.68 |
Where Connecticut 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.