How much rates vary
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 Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $181.97 | Professional | None | $75.86 | $87.10 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.38 Typical High $36.31 | Professional | 53 · Discontinued | $15.49 | $17.38 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $302.00 | Professional | None | $120.23 | $223.87 | $302.00 |
MVP Health Care Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $416.87 | Professional | None | $79.43 | $79.43 | $416.87 |
United Setting Professional Modifier None Typical Low $100.00 Median $218.78 Typical High $416.87 | Professional | None | $100.00 | $218.78 | $416.87 |
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 $38.90 Median $43.65 Typical High $91.20 | Professional | 52 · Reduced service | $38.90 | $43.65 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $64.57 Typical High $134.90 | Professional | 54 · Surgery only | $57.54 | $64.57 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.88 Typical High $27.54 | Professional | 55 · Aftercare only | $11.48 | $12.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $18.20 |
Where Vermont sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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.
Vermont· 15th of 51
$174
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.