How much rates vary
Facilitymedian $2,399 · 10th to 90th $525 to $9,120Professionalmedian $468 · 10th to 90th $251 to $3,090
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 $251.19 Median $2,511.89 Typical High $8,511.38 | Facility | None | $251.19 | $2,511.89 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $467.74 Typical High $1,584.89 | Professional | None | $199.53 | $467.74 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $275.42 Typical High $1,148.15 | Professional | None | $89.13 | $275.42 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $2,041.74 Typical High $6,456.54 | Facility | None | $446.68 | $2,041.74 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $2,089.30 | Professional | None | $269.15 | $416.87 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $169.82 Median $263.03 Typical High $1,318.26 | Professional | 62 · Two surgeons | $169.82 | $263.03 | $1,318.26 |
BCBS Kansas City Setting Professional Modifier None Typical Low $213.80 Median $467.74 Typical High $1,698.24 | Professional | None | $213.80 | $467.74 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $7,762.47 | Facility | None | $1,096.48 | $2,344.23 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $575.44 Typical High $2,570.40 | Professional | None | $229.09 | $575.44 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $2,691.53 Typical High $26,302.68 | Facility | None | $645.65 | $2,691.53 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $4,897.79 Typical High $9,772.37 | Professional | None | $436.52 | $4,897.79 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,818.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $2,454.71 | Professional | None | $263.03 | $446.68 | $2,454.71 |
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 $89.13 Median $251.19 Typical High $630.96 | Professional | 52 · Reduced service | $89.13 | $251.19 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $100.00 Typical High $251.19 | Professional | 53 · Discontinued | $35.48 | $100.00 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $380.19 Typical High $954.99 | Professional | 54 · Surgery only | $131.83 | $380.19 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $75.86 Typical High $190.55 | Professional | 55 · Aftercare only | $26.30 | $75.86 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $50.12 Typical High $125.89 | Professional | 56 · Pre-op care only | $17.78 | $50.12 | $125.89 |
Where Missouri 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.