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 $186.21 Median $229.09 Typical High $794.33 | Professional | None | $186.21 | $229.09 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $1,995.26 | Facility | None | $407.38 | $407.38 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $1,000.00 | Professional | None | $281.84 | $338.84 | $1,000.00 |
MVP Health Care Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,621.81 | Professional | None | $562.34 | $562.34 | $1,621.81 |
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 $229.09 Median $346.74 Typical High $1,047.13 | Professional | None | $229.09 | $346.74 | $1,047.13 |
5 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 $93.33 Median $114.82 Typical High $398.11 | Professional | 52 · Reduced service | $93.33 | $114.82 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $45.71 Typical High $158.49 | Professional | 53 · Discontinued | $37.15 | $45.71 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $602.56 | Professional | 54 · Surgery only | $141.25 | $173.78 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $34.67 Typical High $120.23 | Professional | 55 · Aftercare only | $28.18 | $34.67 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $79.43 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $79.43 |
Where Vermont sits
The same service costs 4.7 times more in Alaska than in Washington, DC. 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· 33rd of 51
$389
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.