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 $181.97 Median $239.88 Typical High $380.19 | Professional | None | $181.97 | $239.88 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $47.86 Typical High $75.86 | Professional | 53 · Discontinued | $36.31 | $47.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $407.38 Typical High $575.44 | Professional | None | $186.21 | $407.38 | $575.44 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $831.76 | Professional | None | $245.47 | $245.47 | $831.76 |
United Setting Professional Modifier None Typical Low $208.93 Median $416.87 Typical High $812.83 | Professional | None | $208.93 | $416.87 | $812.83 |
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 $91.20 Median $120.23 Typical High $190.55 | Professional | 52 · Reduced service | $91.20 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $177.83 Typical High $281.84 | Professional | 54 · Surgery only | $138.04 | $177.83 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $36.31 Typical High $57.54 | Professional | 55 · Aftercare only | $27.54 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.99 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.20 | $23.99 | $38.02 |
Where Vermont sits
The same service costs 3.5 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· 16th of 51
$355
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.