How much rates vary
Facilitymedian $1,380 · 10th to 90th $372 to $4,898Professionalmedian $479 · 10th to 90th $380 to $3,020
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 $501.19 Median $3,715.35 Typical High $7,762.47 | Facility | None | $501.19 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $489.78 | Professional | None | $346.74 | $416.87 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $645.65 | Professional | None | $389.05 | $457.09 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $691.83 Typical High $977.24 | Professional | 50 · Both sides | $588.84 | $691.83 | $977.24 |
BCBS Kansas City Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $645.65 | Professional | None | $416.87 | $501.19 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,187.76 | Facility | None | $602.56 | $1,122.02 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $831.76 | Professional | None | $346.74 | $457.09 | $831.76 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $1,202.26 Typical High $16,218.10 | Facility | None | $407.38 | $1,202.26 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $3,019.95 Typical High $3,311.31 | Professional | None | $467.74 | $3,019.95 | $3,311.31 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $851.14 | Professional | None | $371.54 | $501.19 | $851.14 |
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 $169.82 Median $208.93 Typical High $234.42 | Professional | 52 · Reduced service | $169.82 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $69.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $257.04 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $51.29 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $41.69 Typical High $46.77 | Professional | 56 · Pre-op care only | $34.67 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $239.88 | $288.40 | $331.13 |
Where Missouri 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.