How much rates vary
Facilitymedian $2,570 · 10th to 90th $316 to $9,550Professionalmedian $490 · 10th to 90th $224 to $1,905
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 $323.59 Median $1,819.70 Typical High $9,332.54 | Facility | None | $323.59 | $1,819.70 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $501.19 Typical High $2,041.74 | Professional | None | $194.98 | $501.19 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $691.83 Typical High $1,698.24 | Professional | None | $229.09 | $691.83 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $144.54 Median $426.58 Typical High $1,071.52 | Professional | 62 · Two surgeons | $144.54 | $426.58 | $1,071.52 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $3,162.28 | Professional | None | $223.87 | $245.47 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,778.28 Typical High $3,311.31 | Facility | None | $524.81 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $1,995.26 | Professional | None | $223.87 | $398.11 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $1,479.11 Typical High $1,862.09 | Professional | None | $194.98 | $1,479.11 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | None | $389.05 | $489.78 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $426.58 Typical High $2,511.89 | Facility | None | $257.04 | $426.58 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Sentara Setting Facility Modifier None Typical Low $239.88 Median $1,047.13 Typical High $8,709.64 | Facility | None | $239.88 | $1,047.13 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $338.84 Median $1,778.28 Typical High $5,370.32 | Professional | None | $338.84 | $1,778.28 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $208.93 Median $436.52 Typical High $2,398.83 | Professional | None | $208.93 | $436.52 | $2,398.83 |
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 $95.50 Median $162.18 Typical High $758.58 | Professional | 52 · Reduced service | $95.50 | $162.18 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $64.57 Typical High $302.00 | Professional | 53 · Discontinued | $38.02 | $64.57 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $245.47 Typical High $1,148.15 | Professional | 54 · Surgery only | $144.54 | $245.47 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $48.98 Typical High $229.09 | Professional | 55 · Aftercare only | $28.84 | $48.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $32.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $19.05 | $32.36 | $151.36 |
Where Virginia 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.