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 $95.50 Median $954.99 Typical High $1,096.48 | Professional | None | $95.50 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $19.05 | $190.55 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $1,479.11 | Facility | None | $309.03 | $309.03 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $1,584.89 | Professional | None | $144.54 | $194.98 | $1,584.89 |
MVP Health Care Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,511.89 | Professional | None | $977.24 | $1,348.96 | $2,511.89 |
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 $95.50 Median $933.25 Typical High $1,479.11 | Professional | None | $95.50 | $933.25 | $1,479.11 |
4 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 $47.86 Median $478.63 Typical High $549.54 | Professional | 52 · Reduced service | $47.86 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $724.44 Typical High $831.76 | Professional | 54 · Surgery only | $70.79 | $724.44 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $144.54 Typical High $165.96 | Professional | 55 · Aftercare only | $14.13 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $95.50 Typical High $109.65 | Professional | 56 · Pre-op care only | $9.55 | $95.50 | $109.65 |
Where Vermont sits
The same service costs 14.1 times more in Washington than in Kentucky. 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· 9th of 51
$977
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.