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 $446.68 Median $1,148.15 Typical High $3,630.78 | Professional | None | $446.68 | $1,148.15 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,778.28 | Facility | None | $467.74 | $467.74 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,348.96 | Professional | None | $562.34 | $616.60 | $1,348.96 |
MVP Health Care Setting Professional Modifier None Typical Low $977.24 Median $4,677.35 Typical High $4,677.35 | Professional | None | $977.24 | $4,677.35 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
United Setting Professional Modifier None Typical Low $512.86 Median $1,023.29 Typical High $3,890.45 | Professional | None | $512.86 | $1,023.29 | $3,890.45 |
2 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 54 · Surgery only Typical Low $331.13 Median $851.14 Typical High $2,691.53 | Professional | 54 · Surgery only | $331.13 | $851.14 | $2,691.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $794.33 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $309.03 | $794.33 | $2,511.89 |
Where Vermont sits
The same service costs 4.5 times more in North Carolina than in Washington, DC. 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
$1,072
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.