How much rates vary
Facilitymedian $3,631 · 10th to 90th $708 to $14,125Professionalmedian $380 · 10th to 90th $288 to $631
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 $371.54 Median $602.56 Typical High $8,128.31 | Facility | None | $371.54 | $602.56 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $489.78 | Professional | None | $269.15 | $354.81 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $478.63 | Professional | None | $275.42 | $338.84 | $478.63 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $169.82 Median $213.80 Typical High $302.00 | Professional | 62 · Two surgeons | $169.82 | $213.80 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $3,235.94 | Facility | None | $331.13 | $331.13 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $3,548.13 | Facility | None | $630.96 | $2,344.23 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $870.96 | Professional | None | $331.13 | $478.63 | $870.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,677.35 | Facility | None | $912.01 | $2,290.87 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $851.14 | Professional | None | $354.81 | $616.60 | $851.14 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $724.44 | Professional | None | $281.84 | $416.87 | $724.44 |
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 $151.36 Median $190.55 Typical High $239.88 | Professional | 52 · Reduced service | $151.36 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $95.50 | Professional | 53 · Discontinued | $60.26 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $288.40 Typical High $354.81 | Professional | 54 · Surgery only | $229.09 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $57.54 Typical High $70.79 | Professional | 55 · Aftercare only | $45.71 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $269.15 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $213.80 | $269.15 | $331.13 |
Where Indiana 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.