How much rates vary
Facilitymedian $2,089 · 10th to 90th $631 to $8,128Professionalmedian $631 · 10th to 90th $501 to $1,660
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 $1,174.90 Median $6,025.60 Typical High $15,848.93 | Facility | None | $1,174.90 | $6,025.60 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $954.99 | Professional | None | $501.19 | $602.56 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $1,288.25 Typical High $1,288.25 | Professional | None | $549.54 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,659.59 | Professional | None | $660.69 | $758.58 | $1,659.59 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,511.89 Typical High $6,606.93 | Facility | None | $100.00 | $2,511.89 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $741.31 | Professional | None | $363.08 | $537.03 | $741.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $851.14 | Professional | None | $575.44 | $776.25 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,479.11 Typical High $3,162.28 | Facility | None | $575.44 | $1,479.11 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $977.24 | Professional | None | $512.86 | $602.56 | $977.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $870.96 | Professional | None | $446.68 | $691.83 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,412.54 | Professional | None | $588.84 | $707.95 | $1,412.54 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $4,073.80 | Facility | None | $630.96 | $1,548.82 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $933.25 | Professional | None | $512.86 | $602.56 | $933.25 |
Sutter Health Plus Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
United Setting Facility Modifier None Typical Low $630.96 Median $933.25 Typical High $7,585.78 | Facility | None | $630.96 | $933.25 | $7,585.78 |
United Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,000.00 | Professional | None | $467.74 | $588.84 | $1,000.00 |
7 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 $251.19 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $100.00 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $380.19 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $851.14 Typical High $1,479.11 | Professional | 50 · Both sides | $660.69 | $851.14 | $1,479.11 |
Where California sits
The same service costs 4.8 times more in Vermont than in Maryland. 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 $8,399MD $1,739
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.