How much rates vary
Facilitymedian $6,166 · 10th to 90th $891 to $11,749Professionalmedian $457 · 10th to 90th $331 to $759
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $630.96 | Professional | None | $346.74 | $524.81 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $707.95 | Professional | None | $288.40 | $457.09 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,630.78 Typical High $4,466.84 | Facility | None | $851.14 | $3,630.78 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $870.96 | Professional | None | $457.09 | $537.03 | $870.96 |
ConnectiCare Setting Facility Modifier None Typical Low $676.08 Median $6,760.83 Typical High $6,918.31 | Facility | None | $676.08 | $6,760.83 | $6,918.31 |
ConnectiCare Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | None | $549.54 | $549.54 | $630.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $870.96 | Professional | None | $316.23 | $416.87 | $870.96 |
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 $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $173.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $69.18 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $263.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $52.48 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $34.67 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $245.47 | $363.08 | $363.08 |
Where Connecticut 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.