How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $363.08 Median $426.58 Typical High $537.03 | Professional | None | $363.08 | $426.58 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $660.69 | Facility | None | $309.03 | $309.03 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $616.60 | Professional | None | $457.09 | $501.19 | $616.60 |
MVP Health Care Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,047.13 | Professional | None | $426.58 | $645.65 | $1,047.13 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $776.25 | Professional | None | $398.11 | $489.78 | $776.25 |
6 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 $181.97 Median $229.09 Typical High $269.15 | Professional | 52 · Reduced service | $181.97 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $72.44 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $269.15 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $69.18 Typical High $79.43 | Professional | 55 · Aftercare only | $53.70 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $36.31 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $251.19 | $323.59 | $371.54 |
Where Vermont sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 21st of 51
$479
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.