How much rates vary
Facilitymedian $5,888 · 10th to 90th $955 to $39,811Professionalmedian $1,698 · 10th to 90th $158 to $3,311
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 $1,905.46 Median $12,589.25 Typical High $45,708.82 | Facility | None | $1,905.46 | $12,589.25 | $45,708.82 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,905.46 | $3,162.28 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $2,691.53 | Professional | None | $309.03 | $331.13 | $2,691.53 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1,000.00 Median $27,542.29 Typical High $57,543.99 | Facility | None | $1,000.00 | $27,542.29 | $57,543.99 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,995.26 Median $10,715.19 Typical High $11,220.18 | Professional | None | $1,995.26 | $10,715.19 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $6,456.54 Typical High $12,022.64 | Facility | None | $707.95 | $6,456.54 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $4,265.80 | Professional | None | $1,778.28 | $1,949.84 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $3,630.78 Typical High $10,000.00 | Professional | None | $2,137.96 | $3,630.78 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $1,584.89 Typical High $3,235.94 | Professional | None | $154.88 | $1,584.89 | $3,235.94 |
Pacific Source Setting Facility Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $2,951.21 | Facility | None | $2,454.71 | $2,884.03 | $2,951.21 |
Premera BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,981.07 Typical High $6,309.57 | Facility | None | $1,949.84 | $3,981.07 | $6,309.57 |
Premera BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,952.62 Median $30,199.52 Typical High $57,543.99 | Facility | None | $19,952.62 | $30,199.52 | $57,543.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $2,884.03 Typical High $4,073.80 | Professional | None | $1,995.26 | $2,884.03 | $4,073.80 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $41,686.94 | Facility | None | $2,691.53 | $4,677.35 | $41,686.94 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,862.09 | $2,511.89 | $4,570.88 |
Wellpoint Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,778.28 | $1,862.09 | $2,691.53 |
7 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 $954.99 Median $954.99 Typical High $977.24 | Professional | 52 · Reduced service | $954.99 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | 53 · Discontinued | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,348.96 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $30,199.52 Median $44,668.36 Typical High $85,113.80 | Facility | 50 · Both sides | $30,199.52 | $44,668.36 | $85,113.80 |
Where Washington sits
The same service costs 6.4 times more in Vermont than in Massachusetts. 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 $27,307MA $4,276
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.