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 $123.03 Median $199.53 Typical High $269.15 | Professional | None | $123.03 | $199.53 | $269.15 |
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 $173.78 Median $199.53 Typical High $323.59 | Professional | None | $173.78 | $199.53 | $323.59 |
MVP Health Care Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $512.86 | Professional | None | $223.87 | $281.84 | $512.86 |
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 $147.91 Median $239.88 Typical High $380.19 | Professional | None | $147.91 | $239.88 | $380.19 |
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 $64.57 Median $102.33 Typical High $114.82 | Professional | 52 · Reduced service | $64.57 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $25.70 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $95.50 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $30.90 Typical High $34.67 | Professional | 55 · Aftercare only | $19.05 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.42 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.88 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $144.54 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $89.13 | $144.54 | $158.49 |
Where Vermont sits
The same service costs 3.6 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· 20th of 51
$224
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.