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 $1.20 Median $2.88 Typical High $2.88 | Professional | None | $1.20 | $2.88 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
MVP Health Care Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.17 | Professional | None | $3.31 | $3.31 | $4.17 |
United Setting Professional Modifier None Typical Low $1.86 Median $3.24 Typical High $3.55 | Professional | None | $1.86 | $3.24 | $3.55 |
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 $1.45 Median $1.45 Typical High $1.78 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.71 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.52 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.35 |
Where Vermont sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 33rd of 51
$2.24
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.