How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,096 to $8,913Professionalmedian $912 · 10th to 90th $692 to $7,943
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 $1,698.24 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,230.27 | Professional | None | $831.76 | $891.25 | $1,230.27 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 50 · Both sides | $1,380.38 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,258.93 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,318.26 | Professional | None | $724.44 | $912.01 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,380.38 Typical High $1,995.26 | Professional | 50 · Both sides | $1,096.48 | $1,380.38 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $575.44 Typical High $831.76 | Professional | 62 · Two surgeons | $457.09 | $575.44 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $144.54 Typical High $208.93 | Professional | 80 · Assistant surgeon | $117.49 | $144.54 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $128.82 Typical High $186.21 | Professional | AS · PA/NP assist | $100.00 | $128.82 | $186.21 |
BCBS Kansas City Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,023.29 | Professional | None | $691.83 | $741.31 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $3,311.31 | Facility | None | $758.58 | $2,238.72 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,380.38 | Professional | None | $741.31 | $776.25 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $3,801.89 Typical High $26,302.68 | Facility | None | $870.96 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,380.38 Typical High $7,943.28 | Professional | None | $691.83 | $1,380.38 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,479.11 | Professional | None | $691.83 | $870.96 | $1,479.11 |
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 $416.87 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $165.96 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $630.96 | $691.83 |
Where Missouri 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.