How much rates vary
Facilitymedian $1,820 · 10th to 90th $229 to $6,026Professionalmedian $282 · 10th to 90th $170 to $479
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 $199.53 Median $3,801.89 Typical High $10,000.00 | Facility | None | $199.53 | $3,801.89 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $645.65 | Professional | None | $199.53 | $316.23 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $389.05 | Professional | None | $169.82 | $269.15 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $2,511.89 | Professional | None | $165.96 | $181.97 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $2,187.76 | Facility | None | $478.63 | $954.99 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $478.63 | Professional | None | $173.78 | $288.40 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $380.19 Typical High $467.74 | Professional | None | $154.88 | $380.19 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | None | $478.63 | $588.84 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $512.86 | Facility | None | $199.53 | $316.23 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $186.21 Median $912.01 Typical High $3,630.78 | Facility | None | $186.21 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $2,137.96 | Professional | None | $288.40 | $407.38 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $549.54 | Professional | None | $154.88 | $288.40 | $549.54 |
5 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 $100.00 Median $120.23 Typical High $177.83 | Professional | 52 · Reduced service | $100.00 | $120.23 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $47.86 Typical High $70.79 | Professional | 53 · Discontinued | $39.81 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $181.97 Typical High $263.03 | Professional | 54 · Surgery only | $147.91 | $181.97 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $36.31 Typical High $52.48 | Professional | 55 · Aftercare only | $29.51 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.99 Typical High $35.48 | Professional | 56 · Pre-op care only | $19.95 | $23.99 | $35.48 |
Where Virginia sits
The same service costs 7.0 times more in Vermont than in North Dakota. 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 $4,790ND $687
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.