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 $269.15 Median $346.74 Typical High $446.68 | Professional | None | $269.15 | $346.74 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $616.60 | Facility | None | $467.74 | $467.74 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $602.56 | Professional | None | $363.08 | $389.05 | $602.56 |
MVP Health Care Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $1,023.29 | Professional | None | $407.38 | $537.03 | $1,023.29 |
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 $316.23 Median $436.52 Typical High $676.08 | Professional | None | $316.23 | $436.52 | $676.08 |
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 $138.04 Median $194.98 Typical High $223.87 | Professional | 52 · Reduced service | $138.04 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $77.62 Typical High $89.13 | Professional | 53 · Discontinued | $54.95 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $288.40 Typical High $331.13 | Professional | 54 · Surgery only | $208.93 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $57.54 Typical High $66.07 | Professional | 55 · Aftercare only | $41.69 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $38.90 Typical High $44.67 | Professional | 56 · Pre-op care only | $27.54 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $269.15 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $194.98 | $269.15 | $309.03 |
Where Vermont sits
The same service costs 3.6 times more in Alaska than in Florida. 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
$398
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.