How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,585 to $12,589Professionalmedian $501 · 10th to 90th $372 to $794
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 $446.68 Median $3,235.94 Typical High $10,715.19 | Facility | None | $446.68 | $3,235.94 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $1,479.11 | Professional | None | $346.74 | $389.05 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $812.83 | Professional | None | $398.11 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,454.71 Typical High $3,311.31 | Facility | None | $691.83 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $660.69 | Professional | None | $371.54 | $489.78 | $660.69 |
Denver HMP Setting Facility Modifier None Typical Low $389.05 Median $467.74 Typical High $676.08 | Facility | None | $389.05 | $467.74 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $676.08 | Professional | None | $316.23 | $446.68 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $645.65 Typical High $2,884.03 | Facility | None | $316.23 | $645.65 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $616.60 | Professional | None | $223.87 | $316.23 | $616.60 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $776.25 | Professional | None | $389.05 | $501.19 | $776.25 |
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 $173.78 Median $194.98 Typical High $218.78 | Professional | 52 · Reduced service | $173.78 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $263.03 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $64.57 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $34.67 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $302.00 |
Where Colorado sits
The same service costs 7.8 times more in Vermont than in Montana. 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 $8,433MT $1,087
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.