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 $263.03 Median $323.59 Typical High $1,513.56 | Professional | None | $263.03 | $323.59 | $1,513.56 |
BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $4,570.88 | Professional | None | $1,513.56 | $1,513.56 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $2,344.23 | Professional | None | $354.81 | $724.44 | $2,344.23 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,659.59 | $1,949.84 | $3,311.31 |
United Setting Professional Modifier None Typical Low $323.59 Median $1,348.96 Typical High $3,311.31 | Professional | None | $323.59 | $1,348.96 | $3,311.31 |
5 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 $134.90 Median $162.18 Typical High $741.31 | Professional | 52 · Reduced service | $134.90 | $162.18 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $64.57 Typical High $302.00 | Professional | 53 · Discontinued | $53.70 | $64.57 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $1,122.02 | Professional | 54 · Surgery only | $199.53 | $239.88 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $47.86 Typical High $223.87 | Professional | 55 · Aftercare only | $39.81 | $47.86 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $151.36 |
Where Vermont sits
The same service costs 6.5 times more in Washington than in Maryland. 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· 6th of 51
$1,514
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.