How much rates vary
Facilitymedian $1,585 · 10th to 90th $603 to $5,623Professionalmedian $490 · 10th to 90th $295 to $871
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 $5,370.32 Typical High $7,762.47 | Facility | None | $501.19 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $1,023.29 | Professional | None | $323.59 | $501.19 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $758.58 | Professional | None | $288.40 | $446.68 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $208.93 Median $295.12 Typical High $501.19 | Professional | 62 · Two surgeons | $208.93 | $295.12 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,511.89 | Facility | None | $602.56 | $1,905.46 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $1,096.48 | Professional | None | $363.08 | $588.84 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $812.83 | Professional | None | $363.08 | $562.34 | $812.83 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $1,148.15 | Professional | None | $331.13 | $588.84 | $1,148.15 |
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 $218.78 Typical High $263.03 | Professional | 52 · Reduced service | $162.18 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $64.57 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $245.47 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $43.65 Typical High $52.48 | Professional | 56 · Pre-op care only | $32.36 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $371.54 |
Where Georgia 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.