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 $190.55 Median $245.47 Typical High $295.12 | Professional | None | $190.55 | $245.47 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $660.69 | Facility | None | $309.03 | $309.03 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $389.05 | Professional | None | $257.04 | $275.42 | $389.05 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $660.69 | Professional | None | $269.15 | $363.08 | $660.69 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $457.09 | Professional | None | $223.87 | $302.00 | $457.09 |
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 $128.82 Typical High $144.54 | Professional | 52 · Reduced service | $97.72 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $38.90 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $194.98 Typical High $218.78 | Professional | 54 · Surgery only | $147.91 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.90 Typical High $43.65 | Professional | 55 · Aftercare only | $29.51 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.70 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.50 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $181.97 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $138.04 | $181.97 | $204.17 |
Where Vermont sits
The same service costs 4.2 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· 27th of 51
$275
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.