How much rates vary
Facilitymedian $4,467 · 10th to 90th $871 to $9,550Professionalmedian $589 · 10th to 90th $282 to $2,291
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 $4,570.88 Median $6,760.83 Typical High $10,471.29 | Facility | None | $4,570.88 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $2,089.30 | Professional | None | $275.42 | $389.05 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,365.16 Typical High $14,125.38 | Facility | None | $3,548.13 | $4,365.16 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $707.95 Typical High $2,290.87 | Professional | None | $302.00 | $707.95 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $426.58 Typical High $1,445.44 | Professional | 62 · Two surgeons | $190.55 | $426.58 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $4,466.84 | Facility | None | $851.14 | $3,548.13 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $2,951.21 | Professional | None | $380.19 | $501.19 | $2,951.21 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $3,548.13 | Facility | None | $512.86 | $831.76 | $3,548.13 |
ConnectiCare Setting Professional Modifier None Typical Low $660.69 Median $1,949.84 Typical High $2,570.40 | Professional | None | $660.69 | $1,949.84 | $2,570.40 |
Health New England Setting Facility Modifier None Typical Low $1,737.80 Median $4,677.35 Typical High $7,244.36 | Facility | None | $1,737.80 | $4,677.35 | $7,244.36 |
Health New England Setting Professional Modifier None Typical Low $97.72 Median $467.74 Typical High $501.19 | Professional | None | $97.72 | $467.74 | $501.19 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $281.84 Median $676.08 Typical High $3,715.35 | Professional | None | $281.84 | $676.08 | $3,715.35 |
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 $165.96 Median $186.21 Typical High $1,000.00 | Professional | 52 · Reduced service | $165.96 | $186.21 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $407.38 | Professional | 53 · Discontinued | $66.07 | $74.13 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $1,513.56 | Professional | 54 · Surgery only | $245.47 | $281.84 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $302.00 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $204.17 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $204.17 |
Where Connecticut sits
The same service costs 4.3 times more in Vermont than in Maine. 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 $8,043ME $1,891
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.