How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $69.18 Median $79.43 Typical High $154.88 | Professional | None | $69.18 | $79.43 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.85 Typical High $30.90 | Professional | 53 · Discontinued | $13.80 | $15.85 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $177.83 Typical High $239.88 | Professional | None | $89.13 | $177.83 | $239.88 |
MVP Health Care Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $380.19 | Professional | None | $63.10 | $63.10 | $380.19 |
United Setting Professional Modifier None Typical Low $81.28 Median $204.17 Typical High $398.11 | Professional | None | $81.28 | $204.17 | $398.11 |
4 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 $34.67 Median $39.81 Typical High $77.62 | Professional | 52 · Reduced service | $34.67 | $39.81 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $60.26 Typical High $114.82 | Professional | 54 · Surgery only | $52.48 | $60.26 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.02 Typical High $22.91 | Professional | 55 · Aftercare only | $10.47 | $12.02 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.94 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.92 | $7.94 | $15.49 |
Where Vermont sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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· 25th of 51
$155
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.