How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,072 to $13,490Professionalmedian $1,148 · 10th to 90th $933 to $1,622
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 $1,202.26 Median $4,365.16 Typical High $10,000.00 | Facility | None | $1,202.26 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,202.26 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,412.54 | Professional | None | $977.24 | $1,174.90 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $741.31 Typical High $891.25 | Professional | 62 · Two surgeons | $616.60 | $741.31 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $190.55 Typical High $229.09 | Professional | 80 · Assistant surgeon | $158.49 | $190.55 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $199.53 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,122.02 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $4,168.69 | Facility | None | $478.63 | $2,187.76 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,584.89 | Professional | None | $954.99 | $1,071.52 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,348.96 | Professional | None | $912.01 | $1,096.48 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,949.84 | Facility | None | $1,202.26 | $1,380.38 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,348.96 | Professional | None | $954.99 | $1,318.26 | $1,348.96 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $10,232.93 | Facility | None | $912.01 | $2,454.71 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,348.96 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,905.46 | Professional | None | $707.95 | $1,000.00 | $1,905.46 |
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 $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $537.03 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $831.76 |
Where Virginia 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.