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 $93.33 Median $354.81 Typical High $416.87 | Professional | None | $93.33 | $354.81 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $467.74 | Facility | None | $309.03 | $309.03 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $562.34 | Professional | None | $147.91 | $194.98 | $562.34 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $870.96 | Professional | None | $346.74 | $467.74 | $870.96 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $114.82 Median $354.81 Typical High $602.56 | Professional | None | $114.82 | $354.81 | $602.56 |
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 $46.77 Median $177.83 Typical High $190.55 | Professional | 52 · Reduced service | $46.77 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $19.05 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $269.15 Typical High $288.40 | Professional | 54 · Surgery only | $70.79 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $14.13 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $35.48 Typical High $38.02 | Professional | 56 · Pre-op care only | $9.33 | $35.48 | $38.02 |
Where Vermont sits
The same service costs 4.8 times more in Wisconsin 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· 11th of 51
$363
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.