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 $109.65 Median $389.05 Typical High $616.60 | Professional | None | $109.65 | $389.05 | $616.60 |
BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,819.70 | Professional | None | $512.86 | $512.86 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,122.02 | Facility | None | $467.74 | $467.74 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $831.76 | Professional | None | $162.18 | $218.78 | $831.76 |
MVP Health Care Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $1,174.90 | Professional | None | $501.19 | $575.44 | $1,174.90 |
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 $138.04 Median $436.52 Typical High $831.76 | Professional | None | $138.04 | $436.52 | $831.76 |
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 $54.95 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $54.95 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $85.11 Typical High $93.33 | Professional | 53 · Discontinued | $21.88 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $316.23 Typical High $346.74 | Professional | 54 · Surgery only | $81.28 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $16.22 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $10.96 | $42.66 | $45.71 |
Where Vermont sits
The same service costs 5.6 times more in Washington 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· 16th of 51
$457
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.