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 $177.83 Median $309.03 Typical High $758.58 | Professional | None | $177.83 | $309.03 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,479.11 | Facility | None | $467.74 | $467.74 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $354.81 | Professional | None | $204.17 | $229.09 | $354.81 |
MVP Health Care Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $512.86 | Professional | None | $213.80 | $269.15 | $512.86 |
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 $177.83 Median $245.47 Typical High $398.11 | Professional | None | $177.83 | $245.47 | $398.11 |
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 $87.10 Median $154.88 Typical High $371.54 | Professional | 52 · Reduced service | $87.10 | $154.88 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $61.66 Typical High $151.36 | Professional | 53 · Discontinued | $34.67 | $61.66 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $234.42 Typical High $562.34 | Professional | 54 · Surgery only | $131.83 | $234.42 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $46.77 Typical High $112.20 | Professional | 55 · Aftercare only | $26.30 | $46.77 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $30.90 Typical High $75.86 | Professional | 56 · Pre-op care only | $17.38 | $30.90 | $75.86 |
Where Vermont sits
The same service costs 3.6 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· 15th of 51
$275
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.