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 $134.90 Median $208.93 Typical High $478.63 | Professional | None | $134.90 | $208.93 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $257.04 | Professional | None | $162.18 | $190.55 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $354.81 | Professional | None | $151.36 | $194.98 | $354.81 |
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 $131.83 Median $181.97 Typical High $288.40 | Professional | None | $131.83 | $181.97 | $288.40 |
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 $64.57 Median $104.71 Typical High $239.88 | Professional | 52 · Reduced service | $64.57 | $104.71 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $95.50 | Professional | 53 · Discontinued | $25.70 | $41.69 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $158.49 Typical High $354.81 | Professional | 54 · Surgery only | $97.72 | $158.49 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $31.62 Typical High $70.79 | Professional | 55 · Aftercare only | $19.50 | $31.62 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $47.86 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $47.86 |
Where Vermont sits
The same service costs 3.5 times more in Wyoming than in Maryland. 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· 14th of 51
$200
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.