How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $6,166Professionalmedian $389 · 10th to 90th $234 to $933
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 $3,467.37 Median $5,248.07 Typical High $7,585.78 | Facility | None | $3,467.37 | $5,248.07 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $407.38 | Professional | None | $194.98 | $281.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $102.33 Typical High $194.98 | Professional | 53 · Discontinued | $46.77 | $102.33 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $2,818.38 Typical High $6,606.93 | Facility | None | $1,949.84 | $2,818.38 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $933.25 | Professional | None | $288.40 | $457.09 | $933.25 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $251.19 Typical High $467.74 | Professional | 53 · Discontinued | $169.82 | $251.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $549.54 Typical High $1,023.29 | Facility | None | $524.81 | $549.54 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $977.24 | Facility | None | $446.68 | $602.56 | $977.24 |
ConnectiCare Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $933.25 | Professional | None | $446.68 | $562.34 | $933.25 |
ConnectiCare Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $281.84 Typical High $380.19 | Professional | 53 · Discontinued | $223.87 | $281.84 | $380.19 |
Health New England Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | None | $380.19 | $389.05 | $389.05 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $186.21 Median $398.11 Typical High $870.96 | Professional | None | $186.21 | $398.11 | $870.96 |
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 $95.50 Median $117.49 Typical High $194.98 | Professional | 52 · Reduced service | $95.50 | $117.49 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $295.12 | Professional | 54 · Surgery only | $141.25 | $177.83 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $58.88 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $38.90 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $38.90 |
Where Connecticut 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.