How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,230 to $12,023Professionalmedian $490 · 10th to 90th $331 to $794
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 $489.78 Median $3,235.94 Typical High $8,912.51 | Facility | None | $489.78 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $616.60 | Professional | None | $323.59 | $489.78 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $794.33 | Professional | None | $371.54 | $524.81 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $3,090.30 | Facility | None | $691.83 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $794.33 | Professional | None | $331.13 | $478.63 | $794.33 |
Denver HMP Setting Facility Modifier None Typical Low $323.59 Median $489.78 Typical High $741.31 | Facility | None | $323.59 | $489.78 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $851.14 | Professional | None | $380.19 | $575.44 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $2,754.23 | Facility | None | $512.86 | $954.99 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $512.86 | Professional | None | $323.59 | $407.38 | $512.86 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $891.25 | Professional | None | $346.74 | $512.86 | $891.25 |
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 $162.18 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $64.57 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $245.47 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $32.36 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $229.09 | $309.03 | $338.84 |
Where Colorado sits
The same service costs 11.0 times more in Vermont than in Montana. 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 $12,892MT $1,170
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.