How much rates vary
Facilitymedian $5,012 · 10th to 90th $832 to $12,303Professionalmedian $550 · 10th to 90th $347 to $912
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $724.44 | Professional | None | $354.81 | $478.63 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $11,481.54 Typical High $13,803.84 | Facility | None | $2,754.23 | $11,481.54 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $741.31 | Professional | None | $416.87 | $562.34 | $741.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $338.84 Typical High $467.74 | Professional | 62 · Two surgeons | $257.04 | $338.84 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $1,023.29 | Professional | None | $457.09 | $549.54 | $1,023.29 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $794.33 | Professional | None | $575.44 | $660.69 | $794.33 |
Health New England Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $281.84 Median $562.34 Typical High $1,288.25 | Professional | None | $281.84 | $562.34 | $1,288.25 |
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 $223.87 Median $234.42 Typical High $363.08 | Professional | 52 · Reduced service | $223.87 | $234.42 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $144.54 | Professional | 53 · Discontinued | $89.13 | $93.33 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $549.54 | Professional | 54 · Surgery only | $331.13 | $354.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $109.65 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $72.44 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $512.86 |
Where Connecticut 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.