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 $194.98 Median $302.00 Typical High $346.74 | Professional | None | $194.98 | $302.00 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Facility | None | $467.74 | $467.74 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $537.03 | Professional | None | $275.42 | $309.03 | $537.03 |
MVP Health Care Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $891.25 | Professional | None | $363.08 | $416.87 | $891.25 |
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 $223.87 Median $346.74 Typical High $630.96 | Professional | None | $223.87 | $346.74 | $630.96 |
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 $97.72 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $97.72 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $60.26 Typical High $69.18 | Professional | 53 · Discontinued | $38.90 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $229.09 Typical High $257.04 | Professional | 54 · Surgery only | $147.91 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $29.51 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.50 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $213.80 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $138.04 | $213.80 | $239.88 |
Where Vermont sits
The same service costs 3.5 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· 27th of 51
$331
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.