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 $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 53 · Discontinued | $1.86 | $1.86 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $16.98 Typical High $16.98 | Professional | None | $11.22 | $16.98 | $16.98 |
MVP Health Care Setting Professional Modifier None Typical Low $10.23 Median $12.88 Typical High $12.88 | Professional | None | $10.23 | $12.88 | $12.88 |
United Setting Professional Modifier None Typical Low $7.41 Median $11.48 Typical High $18.62 | Professional | None | $7.41 | $11.48 | $18.62 |
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 $4.68 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.92 Median $7.08 Typical High $7.08 | Professional | 54 · Surgery only | $6.92 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $1.38 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.93 | $0.93 | $0.93 |
Where Vermont sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 9th of 51
$14.79
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.