How much rates vary
Facilitymedian $2,239 · 10th to 90th $562 to $7,244Professionalmedian $1,479 · 10th to 90th $933 to $2,754
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 $5,011.87 Typical High $7,943.28 | Facility | None | $1,174.90 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,174.90 | $2,884.03 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $7,244.36 | Facility | None | $512.86 | $1,174.90 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $2,570.40 | Professional | None | $870.96 | $1,479.11 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $954.99 Typical High $1,698.24 | Professional | 62 · Two surgeons | $660.69 | $954.99 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $269.15 Typical High $436.52 | Professional | 80 · Assistant surgeon | $165.96 | $269.15 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $213.80 Typical High $380.19 | Professional | AS · PA/NP assist | $147.91 | $213.80 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,454.71 Typical High $3,162.28 | Facility | None | $524.81 | $2,454.71 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,737.80 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,258.93 | $1,949.84 |
Oscar Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,819.70 | $1,905.46 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,584.89 Typical High $2,884.03 | Professional | None | $933.25 | $1,584.89 | $2,884.03 |
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 $537.03 Median $537.03 Typical High $630.96 | Professional | 52 · Reduced service | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $870.96 |
Where Georgia 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.