How much rates vary
Facilitymedian $3,020 · 10th to 90th $407 to $9,333Professionalmedian $380 · 10th to 90th $302 to $646
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 $354.81 Median $3,981.07 Typical High $9,332.54 | Facility | None | $354.81 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $676.08 | Professional | None | $338.84 | $512.86 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $436.52 | Professional | None | $302.00 | $363.08 | $436.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $229.09 Typical High $275.42 | Professional | 62 · Two surgeons | $190.55 | $229.09 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $467.74 | Professional | None | $323.59 | $354.81 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $691.83 | Professional | None | $316.23 | $446.68 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $741.31 | Professional | None | $489.78 | $588.84 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $602.56 | Professional | None | $478.63 | $602.56 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $549.54 Typical High $891.25 | Facility | None | $354.81 | $549.54 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $537.03 | Professional | None | $407.38 | $436.52 | $537.03 |
Sentara Setting Facility Modifier None Typical Low $295.12 Median $1,445.44 Typical High $8,709.64 | Facility | None | $295.12 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $1,174.90 | Professional | None | $380.19 | $537.03 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $741.31 | Professional | None | $245.47 | $398.11 | $741.31 |
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 $165.96 Median $229.09 Typical High $275.42 | Professional | 52 · Reduced service | $165.96 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $91.20 Typical High $109.65 | Professional | 53 · Discontinued | $67.61 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $251.19 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $50.12 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $45.71 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.88 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $323.59 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $234.42 | $323.59 | $380.19 |
Where Virginia 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.