How much rates vary
Facilitymedian $1,514 · 10th to 90th $389 to $4,786Professionalmedian $427 · 10th to 90th $331 to $676
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 $426.58 Median $2,238.72 Typical High $5,011.87 | Facility | None | $426.58 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | None | $389.05 | $426.58 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $741.31 | Professional | None | $398.11 | $457.09 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $1,318.26 | Facility | None | $501.19 | $912.01 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $630.96 | Professional | None | $331.13 | $354.81 | $630.96 |
Hometown Health Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $851.14 | Professional | None | $275.42 | $457.09 | $851.14 |
Hometown Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $1.82 Median $616.60 Typical High $1,380.38 | Professional | None | $1.82 | $616.60 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $489.78 Typical High $4,265.80 | Facility | None | $407.38 | $489.78 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $831.76 | Professional | None | $331.13 | $446.68 | $831.76 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $660.69 | Professional | None | $309.03 | $416.87 | $660.69 |
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 $194.98 Median $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $77.62 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $295.12 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $309.03 |
Where Nevada 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.