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 $371.54 Median $467.74 Typical High $524.81 | Professional | None | $371.54 | $467.74 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $3,311.31 | Facility | None | $309.03 | $309.03 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $707.95 | Professional | None | $489.78 | $524.81 | $707.95 |
MVP Health Care Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,174.90 | Professional | None | $478.63 | $630.96 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $831.76 | Professional | None | $426.58 | $524.81 | $831.76 |
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 $190.55 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $190.55 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $75.86 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $288.40 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $69.18 Typical High $79.43 | Professional | 55 · Aftercare only | $57.54 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $38.02 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $269.15 | $323.59 | $371.54 |
Where Vermont sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 22nd of 51
$525
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.