How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,122 to $5,495Professionalmedian $832 · 10th to 90th $631 to $1,202
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 $1,000.00 Median $3,162.28 Typical High $7,244.36 | Facility | None | $1,000.00 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,202.26 | Professional | None | $758.58 | $831.76 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,230.27 | Professional | None | $794.33 | $891.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,905.46 Typical High $2,630.27 | Facility | None | $724.44 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $1,202.26 | Professional | None | $537.03 | $812.83 | $1,202.26 |
Hometown Health Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,202.26 | Professional | None | $630.96 | $831.76 | $1,202.26 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $1,047.13 | Professional | None | $10.00 | $10.00 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $4,265.80 | Facility | None | $691.83 | $691.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,288.25 | Professional | None | $645.65 | $912.01 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,202.26 | Professional | None | $616.60 | $776.25 | $1,202.26 |
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 $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $691.83 |
Where Nevada 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.