How much rates vary
Facilitymedian $4,365 · 10th to 90th $851 to $10,965Professionalmedian $871 · 10th to 90th $661 to $1,230
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 $1,047.13 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,047.13 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $3,715.35 | Professional | None | $660.69 | $1,047.13 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,071.52 | Professional | None | $758.58 | $891.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,348.96 Typical High $1,584.89 | Professional | 50 · Both sides | $1,122.02 | $1,348.96 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $676.08 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $144.54 Typical High $169.82 | Professional | 80 · Assistant surgeon | $120.23 | $144.54 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $125.89 Typical High $147.91 | Professional | AS · PA/NP assist | $104.71 | $125.89 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,000.00 | Professional | None | $758.58 | $831.76 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,311.31 | Facility | None | $645.65 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,148.15 | Professional | None | $676.08 | $776.25 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $977.24 | Professional | None | $691.83 | $794.33 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $912.01 Typical High $1,380.38 | Facility | None | $660.69 | $912.01 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $1,862.09 Typical High $10,232.93 | Facility | None | $616.60 | $1,862.09 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $6,025.60 | Professional | None | $602.56 | $891.25 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,230.27 | Professional | None | $549.54 | $741.31 | $1,230.27 |
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 $331.13 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $331.13 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $131.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $489.78 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $97.72 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $66.07 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $457.09 | $724.44 | $724.44 |
Where Virginia 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.