How much rates vary
Facilitymedian $5,623 · 10th to 90th $977 to $14,125Professionalmedian $1,622 · 10th to 90th $933 to $2,630
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,137.96 | Professional | None | $891.25 | $1,621.81 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $1,000.00 Typical High $1,348.96 | Professional | 62 · Two surgeons | $562.34 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $251.19 Typical High $338.84 | Professional | 80 · Assistant surgeon | $141.25 | $251.19 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $218.78 Typical High $302.00 | Professional | AS · PA/NP assist | $125.89 | $218.78 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,466.84 Typical High $5,495.41 | Facility | None | $741.31 | $4,466.84 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,659.59 | $2,884.03 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,445.44 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,479.11 Typical High $3,090.30 | Professional | None | $831.76 | $1,479.11 | $3,090.30 |
6 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 $588.84 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $588.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $239.88 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $891.25 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $177.83 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $831.76 | $1,230.27 | $1,230.27 |
Where Connecticut sits
The same service costs 5.3 times more in Vermont than in Hawaii. 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 $13,652HI $2,577
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.