How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,072 to $5,754Professionalmedian $1,072 · 10th to 90th $813 to $1,698
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 $1,071.52 Median $2,238.72 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,047.13 | $1,071.52 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,202.26 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,290.87 Typical High $3,235.94 | Facility | None | $501.19 | $2,290.87 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,548.82 | Professional | None | $794.33 | $891.25 | $1,548.82 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $891.25 Typical High $1,584.89 | Professional | None | $9.55 | $891.25 | $1,584.89 |
Hometown Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Hometown Health Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $1,380.38 | Professional | None | $7.24 | $7.24 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $4,265.80 | Facility | None | $933.25 | $933.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,905.46 | Professional | None | $741.31 | $933.25 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,584.89 | Professional | None | $812.83 | $1,047.13 | $1,584.89 |
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 $524.81 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $524.81 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $741.31 |
Where Nevada 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.