How much rates vary
Facilitymedian $794 · 10th to 90th $126 to $10,233Professionalmedian $158 · 10th to 90th $123 to $282
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 $245.47 Median $2,344.23 Typical High $10,964.78 | Facility | None | $245.47 | $2,344.23 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $2,630.27 | Professional | None | $134.90 | $181.97 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $190.55 | Professional | None | $109.65 | $151.36 | $190.55 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $218.78 Typical High $281.84 | Professional | 50 · Both sides | $218.78 | $218.78 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $10,715.19 Typical High $18,620.87 | Facility | None | $3,630.78 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $234.42 | Professional | None | $123.03 | $147.91 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $218.78 Typical High $346.74 | Professional | 50 · Both sides | $186.21 | $218.78 | $346.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.95 Median $23.44 Typical High $37.15 | Professional | 80 · Assistant surgeon | $19.95 | $23.44 | $37.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $20.42 Typical High $32.36 | Professional | AS · PA/NP assist | $17.38 | $20.42 | $32.36 |
Aultcare Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $245.47 | Professional | None | $169.82 | $245.47 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $177.83 | Professional | None | $158.49 | $165.96 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $2,691.53 | Facility | None | $501.19 | $794.33 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $295.12 | Professional | None | $138.04 | $154.88 | $295.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $5,248.07 | Facility | None | $512.86 | $1,659.59 | $5,248.07 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $346.74 | Professional | None | $141.25 | $177.83 | $346.74 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $223.87 | Professional | None | $125.89 | $165.96 | $223.87 |
SummaCare Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $234.42 | Professional | None | $125.89 | $154.88 | $234.42 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $323.59 | Professional | None | $131.83 | $165.96 | $323.59 |
1 more rate 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 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $223.87 | Professional | 54 · Surgery only | $102.33 | $102.33 | $223.87 |
Where Ohio sits
The same service costs 17.8 times more in Vermont than in Delaware. 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 $5,439DE $306
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.