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 $229.09 Median $309.03 Typical High $407.38 | Professional | None | $229.09 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $46.77 | $60.26 | $70.79 |
BCBS Vermont Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $1,230.27 | Professional | None | $354.81 | $354.81 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $3,162.28 | Facility | None | $467.74 | $467.74 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $602.56 Typical High $602.56 | Professional | None | $302.00 | $602.56 | $602.56 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $851.14 | Professional | None | $346.74 | $426.58 | $851.14 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
United Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $707.95 | Professional | None | $257.04 | $478.63 | $707.95 |
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 $117.49 Median $151.36 Typical High $177.83 | Professional | 52 · Reduced service | $117.49 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $173.78 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $45.71 Typical High $53.70 | Professional | 55 · Aftercare only | $34.67 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.44 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $208.93 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $162.18 | $208.93 | $251.19 |
Where Vermont sits
The same service costs 4.6 times more in Alaska 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· 14th of 51
$479
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.