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 $416.87 Median $478.63 Typical High $537.03 | Professional | None | $416.87 | $478.63 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $3,311.31 | Facility | None | $309.03 | $309.03 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $676.08 | Professional | None | $537.03 | $575.44 | $676.08 |
MVP Health Care Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,148.15 | Professional | None | $467.74 | $645.65 | $1,148.15 |
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 $446.68 Median $549.54 Typical High $891.25 | Professional | None | $446.68 | $549.54 | $891.25 |
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 $218.78 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $218.78 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $87.10 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $323.59 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $302.00 | $338.84 | $371.54 |
Where Vermont sits
The same service costs 4.5 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· 19th of 51
$575
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.