How much rates vary
Facilitymedian $2,188 · 10th to 90th $513 to $5,129Professionalmedian $363 · 10th to 90th $204 to $676
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 $281.84 Median $3,090.30 Typical High $8,912.51 | Facility | None | $281.84 | $3,090.30 | $8,912.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $74.13 Median $141.25 Typical High $275.42 | Facility | 53 · Discontinued | $74.13 | $141.25 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $457.09 | Professional | None | $186.21 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $77.62 Typical High $169.82 | Professional | 53 · Discontinued | $40.74 | $77.62 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $3,311.31 Typical High $5,370.32 | Facility | None | $1,778.28 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $676.08 | Professional | None | $223.87 | $398.11 | $676.08 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $186.21 Typical High $323.59 | Professional | 53 · Discontinued | $83.18 | $186.21 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $524.81 Typical High $2,187.76 | Facility | None | $501.19 | $524.81 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Denver HMP Setting Facility Modifier None Typical Low $181.97 Median $346.74 Typical High $549.54 | Facility | None | $181.97 | $346.74 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $676.08 | Professional | None | $208.93 | $389.05 | $676.08 |
Kaiser Permanente Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $194.98 Typical High $331.13 | Professional | 53 · Discontinued | $104.71 | $194.98 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $724.44 Typical High $851.14 | Facility | None | $331.13 | $724.44 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $389.05 | Professional | None | $151.36 | $213.80 | $389.05 |
Select Health Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $102.33 Typical High $194.98 | Professional | 53 · Discontinued | $75.86 | $102.33 | $194.98 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $602.56 | Professional | None | $213.80 | $363.08 | $602.56 |
4 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 $85.11 Median $102.33 Typical High $165.96 | Professional | 52 · Reduced service | $85.11 | $102.33 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $169.82 Typical High $288.40 | Professional | 54 · Surgery only | $138.04 | $169.82 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.88 Typical High $57.54 | Professional | 55 · Aftercare only | $27.54 | $33.88 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.39 Typical High $38.90 | Professional | 56 · Pre-op care only | $18.62 | $22.39 | $38.90 |
Where Colorado sits
The same service costs 5.8 times more in Vermont than in Maine. 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 $4,478ME $766
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.