How much rates vary
Facilitymedian $794 · 10th to 90th $214 to $4,074Professionalmedian $302 · 10th to 90th $178 to $447
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 $263.03 Median $645.65 Typical High $7,244.36 | Facility | None | $263.03 | $645.65 | $7,244.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $72.44 Median $131.83 Typical High $223.87 | Facility | 53 · Discontinued | $72.44 | $131.83 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $478.63 | Professional | None | $194.98 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $75.86 Typical High $177.83 | Professional | 53 · Discontinued | $38.90 | $75.86 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $2,951.21 | Facility | None | $1,000.00 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $416.87 | Professional | None | $173.78 | $281.84 | $416.87 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $169.82 Typical High $380.19 | Professional | 53 · Discontinued | $75.86 | $169.82 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,513.56 | $1,995.26 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $512.86 Typical High $2,187.76 | Facility | None | $457.09 | $512.86 | $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 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $645.65 | Professional | None | $371.54 | $436.52 | $645.65 |
Kaiser Permanente Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $436.52 Typical High $645.65 | Professional | 53 · Discontinued | $371.54 | $436.52 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $602.56 | Professional | None | $478.63 | $602.56 | $602.56 |
Medcost Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $194.98 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $588.84 | Facility | None | $213.80 | $346.74 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $436.52 | Professional | None | $173.78 | $331.13 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $457.09 Typical High $2,570.40 | Facility | None | $165.96 | $457.09 | $2,570.40 |
Sentara Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $588.84 | Professional | None | $331.13 | $416.87 | $588.84 |
Sentara Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $190.55 Typical High $354.81 | Professional | 53 · Discontinued | $134.90 | $190.55 | $354.81 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $537.03 | Professional | None | $162.18 | $288.40 | $537.03 |
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 $97.72 Median $97.72 Typical High $107.15 | Professional | 52 · Reduced service | $97.72 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $158.49 Typical High $288.40 | Professional | 54 · Surgery only | $147.91 | $158.49 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $31.62 Typical High $57.54 | Professional | 55 · Aftercare only | $29.51 | $31.62 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.38 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.50 | $21.38 | $38.02 |
Where Virginia 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.