How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,445 to $9,772Professionalmedian $1,072 · 10th to 90th $813 to $1,698
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 $1,096.48 Median $2,570.40 Typical High $6,165.95 | Facility | None | $1,096.48 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,000.00 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $11,220.18 | Facility | None | $4,570.88 | $7,762.47 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,174.90 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $4,073.80 Typical High $5,754.40 | Facility | None | $616.60 | $4,073.80 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,548.82 | Professional | None | $831.76 | $870.96 | $1,548.82 |
Hometown Health Setting Professional Modifier None Typical Low $14.13 Median $933.25 Typical High $1,584.89 | Professional | None | $14.13 | $933.25 | $1,584.89 |
Hometown Health Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $1,412.54 | Professional | None | $10.47 | $10.47 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $4,265.80 | Facility | None | $933.25 | $933.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,905.46 | Professional | None | $741.31 | $933.25 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,621.81 | Professional | None | $812.83 | $1,047.13 | $1,621.81 |
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 $501.19 Median $501.19 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | 53 · Discontinued | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $776.25 |
Where Nevada sits
The same service costs 6.2 times more in Vermont than in Hawaii. 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 $19,228HI $3,097
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.