How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,096 to $15,849Professionalmedian $1,148 · 10th to 90th $933 to $1,660
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 $1,862.09 Median $5,495.41 Typical High $14,791.08 | Facility | None | $1,862.09 | $5,495.41 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,174.90 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,412.54 | Professional | None | $977.24 | $1,174.90 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,737.80 Typical High $2,137.96 | Professional | 50 · Both sides | $1,479.11 | $1,737.80 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $741.31 Typical High $891.25 | Professional | 62 · Two surgeons | $616.60 | $741.31 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,148.15 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $7,079.46 | Facility | None | $524.81 | $3,019.95 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,621.81 | Professional | None | $977.24 | $1,047.13 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,380.38 | Professional | None | $912.01 | $1,096.48 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,737.80 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,905.46 | Facility | None | $1,174.90 | $1,348.96 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,258.93 | Professional | None | $912.01 | $1,023.29 | $1,258.93 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $11,481.54 | Facility | None | $912.01 | $2,818.38 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,230.27 | $2,454.71 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $10,232.93 Typical High $25,118.86 | Facility | None | $2,754.23 | $10,232.93 | $25,118.86 |
United Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,862.09 | Professional | None | $724.44 | $954.99 | $1,862.09 |
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 $537.03 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $537.03 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $213.80 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $812.83 |
Where Virginia 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.