How much rates vary
Facilitymedian $1,862 · 10th to 90th $603 to $6,166Professionalmedian $468 · 10th to 90th $316 to $912
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 $346.74 Median $5,370.32 Typical High $7,762.47 | Facility | None | $346.74 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $912.01 | Professional | None | $346.74 | $416.87 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $616.60 | Professional | None | $295.12 | $309.03 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $812.83 | Professional | None | $316.23 | $467.74 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,630.27 | Facility | None | $602.56 | $1,995.26 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $954.99 | Professional | None | $389.05 | $524.81 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $1,096.48 | Professional | None | $323.59 | $398.11 | $1,096.48 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $954.99 | Professional | None | $346.74 | $501.19 | $954.99 |
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 $173.78 Typical High $223.87 | Professional | 52 · Reduced service | $173.78 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | 53 · Discontinued | $69.18 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $316.23 |
Where Georgia 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.