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 $288.40 Median $346.74 Typical High $371.54 | Professional | None | $288.40 | $346.74 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $6,760.83 | Facility | None | $407.38 | $407.38 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $489.78 | Professional | None | $363.08 | $389.05 | $489.78 |
MVP Health Care Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $831.76 | Professional | None | $338.84 | $457.09 | $831.76 |
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 $323.59 Median $398.11 Typical High $588.84 | Professional | None | $323.59 | $398.11 | $588.84 |
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 $144.54 Median $173.78 Typical High $186.21 | Professional | 52 · Reduced service | $144.54 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $69.18 Typical High $74.13 | Professional | 53 · Discontinued | $57.54 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $257.04 Typical High $281.84 | Professional | 54 · Surgery only | $213.80 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $51.29 Typical High $56.23 | Professional | 55 · Aftercare only | $42.66 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $34.67 Typical High $37.15 | Professional | 56 · Pre-op care only | $28.84 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $239.88 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $199.53 | $239.88 | $263.03 |
Where Vermont sits
The same service costs 4.3 times more in Alaska than in Texas. 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· 23rd of 51
$389
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.