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 $120.23 Median $213.80 Typical High $281.84 | Professional | None | $120.23 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $46.77 Typical High $56.23 | Professional | 53 · Discontinued | $24.55 | $46.77 | $56.23 |
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 $186.21 Median $204.17 Typical High $380.19 | Professional | None | $186.21 | $204.17 | $380.19 |
MVP Health Care Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $524.81 | Professional | None | $223.87 | $346.74 | $524.81 |
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 $123.03 Median $218.78 Typical High $389.05 | Professional | None | $123.03 | $218.78 | $389.05 |
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 $61.66 Median $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $61.66 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $93.33 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $18.62 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $12.30 | $23.44 | $28.18 |
Where Vermont sits
The same service costs 3.8 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· 22nd 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.