How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $190.55 Median $245.47 Typical High $380.19 | Professional | None | $190.55 | $245.47 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $50.12 Typical High $77.62 | Professional | 53 · Discontinued | $38.02 | $50.12 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $588.84 | Professional | None | $204.17 | $389.05 | $588.84 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $870.96 | Professional | None | $269.15 | $269.15 | $870.96 |
United Setting Professional Modifier None Typical Low $218.78 Median $457.09 Typical High $891.25 | Professional | None | $218.78 | $457.09 | $891.25 |
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 $95.50 Median $123.03 Typical High $190.55 | Professional | 52 · Reduced service | $95.50 | $123.03 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $186.21 Typical High $288.40 | Professional | 54 · Surgery only | $141.25 | $186.21 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $37.15 Typical High $57.54 | Professional | 55 · Aftercare only | $28.18 | $37.15 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $38.02 |
Where Vermont sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 17th of 51
$372
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.