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 $181.97 Median $263.03 Typical High $389.05 | Professional | None | $181.97 | $263.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $602.56 | Facility | None | $309.03 | $309.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $467.74 | Professional | None | $251.19 | $295.12 | $467.74 |
MVP Health Care Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $776.25 | Professional | None | $316.23 | $371.54 | $776.25 |
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 $208.93 Median $288.40 Typical High $549.54 | Professional | None | $208.93 | $288.40 | $549.54 |
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 $93.33 Median $131.83 Typical High $151.36 | Professional | 52 · Reduced service | $93.33 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $52.48 Typical High $60.26 | Professional | 53 · Discontinued | $37.15 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $199.53 Typical High $229.09 | Professional | 54 · Surgery only | $138.04 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $39.81 Typical High $45.71 | Professional | 55 · Aftercare only | $27.54 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $18.62 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $186.21 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $128.82 | $186.21 | $213.80 |
Where Vermont sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 25th of 51
$295
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.