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 $239.88 Median $309.03 Typical High $346.74 | Professional | None | $239.88 | $309.03 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $1,479.11 | Facility | None | $407.38 | $407.38 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $457.09 | Professional | None | $323.59 | $346.74 | $457.09 |
MVP Health Care Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $776.25 | Professional | None | $316.23 | $426.58 | $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 $288.40 Median $371.54 Typical High $549.54 | Professional | None | $288.40 | $371.54 | $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 $125.89 Median $154.88 Typical High $173.78 | Professional | 52 · Reduced service | $125.89 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $61.66 Typical High $69.18 | Professional | 53 · Discontinued | $50.12 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $186.21 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $37.15 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.90 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.12 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $213.80 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $173.78 | $213.80 | $245.47 |
Where Vermont sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 24th of 51
$347
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.