How much rates vary
Facilitymedian $1,820 · 10th to 90th $372 to $3,890Professionalmedian $562 · 10th to 90th $245 to $2,692
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 $288.40 Median $389.05 Typical High $2,754.23 | Facility | None | $288.40 | $389.05 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $1,584.89 | Professional | None | $288.40 | $389.05 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $478.63 | Professional | None | $194.98 | $213.80 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $524.81 Typical High $1,862.09 | Professional | None | $204.17 | $524.81 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $331.13 Typical High $1,445.44 | Professional | 62 · Two surgeons | $190.55 | $331.13 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,019.95 Typical High $4,168.69 | Facility | None | $660.69 | $3,019.95 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $724.44 Typical High $3,311.31 | Professional | None | $288.40 | $724.44 | $3,311.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,168.69 | Facility | None | $1,698.24 | $1,949.84 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $269.15 Median $1,230.27 Typical High $4,073.80 | Professional | None | $269.15 | $1,230.27 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,168.69 | Facility | None | $1,698.24 | $2,089.30 | $4,168.69 |
United Setting Professional Modifier None Typical Low $316.23 Median $707.95 Typical High $3,162.28 | Professional | None | $316.23 | $707.95 | $3,162.28 |
Well Sense Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $144.54 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $144.54 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $57.54 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $218.78 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $43.65 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.84 | $38.90 | $38.90 |
Where New Hampshire 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.