How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,820 to $12,589Professionalmedian $977 · 10th to 90th $741 to $1,778
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 $1,659.59 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,659.59 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,202.26 | Professional | None | $724.44 | $954.99 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,995.26 | Professional | None | $870.96 | $1,174.90 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,454.71 Typical High $3,311.31 | Facility | None | $831.76 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,318.26 | Professional | None | $676.08 | $891.25 | $1,318.26 |
Denver HMP Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,778.28 | Facility | None | $794.33 | $954.99 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,412.54 | Professional | None | $724.44 | $933.25 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $1,445.44 Typical High $2,884.03 | Facility | None | $724.44 | $1,445.44 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,047.13 | Professional | None | $501.19 | $794.33 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,584.89 | Professional | None | $691.83 | $954.99 | $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 $389.05 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $676.08 |
Where Colorado sits
The same service costs 3.6 times more in Vermont than in Montana. 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 $8,561MT $2,405
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.