How much rates vary
Facilitymedian $5,495 · 10th to 90th $891 to $11,749Professionalmedian $1,230 · 10th to 90th $708 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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,202.26 | Professional | None | $812.83 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,318.26 Typical High $1,659.59 | Professional | None | $741.31 | $1,318.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,949.84 Typical High $2,511.89 | Professional | 50 · Both sides | $1,122.02 | $1,949.84 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $831.76 Typical High $1,047.13 | Professional | 62 · Two surgeons | $467.74 | $831.76 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $208.93 Typical High $263.03 | Professional | 80 · Assistant surgeon | $117.49 | $208.93 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $181.97 Typical High $234.42 | Professional | AS · PA/NP assist | $104.71 | $181.97 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $4,786.30 | Facility | None | $1,000.00 | $3,630.78 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,819.70 | Professional | None | $660.69 | $977.24 | $1,819.70 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $1,288.25 | Professional | None | $512.86 | $851.14 | $1,288.25 |
Health New England Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Facility | None | $4,168.69 | $4,168.69 | $4,168.69 |
Health New England Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $2,511.89 | Professional | None | $691.83 | $933.25 | $2,511.89 |
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 $446.68 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $446.68 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $177.83 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $676.08 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $134.90 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $89.13 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $630.96 | $851.14 | $851.14 |
Where Connecticut 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.