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 $190.55 Median $331.13 Typical High $416.87 | Professional | None | $190.55 | $331.13 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,995.26 | Facility | None | $467.74 | $467.74 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $588.84 | Professional | None | $281.84 | $309.03 | $588.84 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $831.76 | Professional | None | $346.74 | $524.81 | $831.76 |
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 $239.88 Median $363.08 Typical High $691.83 | Professional | None | $239.88 | $363.08 | $691.83 |
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 $95.50 Median $165.96 Typical High $208.93 | Professional | 52 · Reduced service | $95.50 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $66.07 Typical High $83.18 | Professional | 53 · Discontinued | $38.02 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $251.19 Typical High $316.23 | Professional | 54 · Surgery only | $144.54 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $50.12 Typical High $63.10 | Professional | 55 · Aftercare only | $28.84 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $33.11 Typical High $41.69 | Professional | 56 · Pre-op care only | $19.05 | $33.11 | $41.69 |
Where Vermont sits
The same service costs 4.0 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· 27th of 51
$339
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.