How much rates vary
Facilitymedian $1,862 · 10th to 90th $708 to $6,310Professionalmedian $1,047 · 10th to 90th $692 to $1,905
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 $912.01 Median $5,370.32 Typical High $8,317.64 | Facility | None | $912.01 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $2,398.83 | Professional | None | $912.01 | $1,000.00 | $2,398.83 |
Ambetter Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $5,754.40 | Facility | None | $676.08 | $1,348.96 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,548.82 | Professional | None | $676.08 | $1,047.13 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,584.89 Typical High $2,290.87 | Professional | 50 · Both sides | $1,148.15 | $1,584.89 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $660.69 Typical High $977.24 | Professional | 62 · Two surgeons | $478.63 | $660.69 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $169.82 Typical High $245.47 | Professional | 80 · Assistant surgeon | $123.03 | $169.82 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $147.91 Typical High $213.80 | Professional | AS · PA/NP assist | $107.15 | $147.91 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $2,691.53 | Facility | None | $741.31 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $2,137.96 | Professional | None | $794.33 | $1,230.27 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,778.28 | Professional | None | $812.83 | $933.25 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | None | $1,023.29 | $1,023.29 | $1,174.90 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $2,187.76 | Professional | None | $724.44 | $1,096.48 | $2,187.76 |
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 $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $707.95 |
Where Georgia 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.