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 $41.69 Median $147.91 Typical High $181.97 | Professional | None | $41.69 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $29.51 Typical High $36.31 | Professional | 53 · Discontinued | $8.51 | $29.51 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $138.04 Typical High $275.42 | Professional | None | $70.79 | $138.04 | $275.42 |
MVP Health Care Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $407.38 | Professional | None | $165.96 | $223.87 | $407.38 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
United Setting Professional Modifier None Typical Low $46.77 Median $128.82 Typical High $245.47 | Professional | None | $46.77 | $128.82 | $245.47 |
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 $20.89 Median $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $20.89 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $112.20 Typical High $134.90 | Professional | 54 · Surgery only | $31.62 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $22.39 Typical High $26.92 | Professional | 55 · Aftercare only | $6.31 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $14.79 Typical High $18.20 | Professional | 56 · Pre-op care only | $4.27 | $14.79 | $18.20 |
Where Vermont sits
The same service costs 4.6 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· 16th of 51
$151
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.