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 $63.10 Median $87.10 Typical High $97.72 | Professional | None | $63.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $17.38 Typical High $19.50 | Professional | 53 · Discontinued | $13.18 | $17.38 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $309.03 | Facility | None | $107.15 | $107.15 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $112.20 | Professional | None | $87.10 | $97.72 | $112.20 |
MVP Health Care Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $204.17 | Professional | None | $81.28 | $120.23 | $204.17 |
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 $74.13 Median $97.72 Typical High $141.25 | Professional | None | $74.13 | $97.72 | $141.25 |
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 $32.36 Median $43.65 Typical High $48.98 | Professional | 52 · Reduced service | $32.36 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $64.57 Typical High $72.44 | Professional | 54 · Surgery only | $48.98 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.18 Typical High $14.79 | Professional | 55 · Aftercare only | $9.77 | $13.18 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.71 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.46 | $8.71 | $9.77 |
Where Vermont sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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
$91.20
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.