How much rates vary
Facilitymedian $1,122 · 10th to 90th $195 to $5,623Professionalmedian $302 · 10th to 90th $132 to $490
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 $169.82 Median $524.81 Typical High $8,317.64 | Facility | None | $169.82 | $524.81 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $346.74 Typical High $562.34 | Professional | None | $158.49 | $346.74 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $2,951.21 | Facility | None | $1,000.00 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $302.00 Typical High $457.09 | Professional | None | $131.83 | $302.00 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $173.78 | Professional | None | $131.83 | $147.91 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $660.69 Typical High $2,187.76 | Facility | None | $457.09 | $660.69 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $309.03 Typical High $457.09 | Professional | None | $134.90 | $309.03 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $602.56 | Professional | None | $407.38 | $478.63 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $512.86 | Professional | None | $416.87 | $512.86 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $645.65 | Facility | None | $158.49 | $257.04 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $436.52 | Professional | None | $309.03 | $354.81 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $147.91 Median $933.25 Typical High $3,630.78 | Facility | None | $147.91 | $933.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $691.83 | Professional | None | $354.81 | $407.38 | $691.83 |
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 $120.23 Median $275.42 Typical High $512.86 | Professional | None | $120.23 | $275.42 | $512.86 |
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 $79.43 Median $134.90 Typical High $229.09 | Professional | 52 · Reduced service | $79.43 | $134.90 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $53.70 Typical High $93.33 | Professional | 53 · Discontinued | $31.62 | $53.70 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $204.17 Typical High $346.74 | Professional | 54 · Surgery only | $117.49 | $204.17 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $40.74 Typical High $69.18 | Professional | 55 · Aftercare only | $23.44 | $40.74 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $26.92 Typical High $46.77 | Professional | 56 · Pre-op care only | $15.85 | $26.92 | $46.77 |
Where Virginia sits
The same service costs 4.2 times more in Vermont than in Maryland. 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 $3,301MD $784
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.