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 $34.67 Median $42.66 Typical High $57.54 | Professional | None | $34.67 | $42.66 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $47.86 Typical High $54.95 | Facility | None | $44.67 | $47.86 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | RR · Rental | $109.65 | $109.65 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $93.33 | Professional | None | $63.10 | $77.62 | $93.33 |
United Setting Professional Modifier None Typical Low $22.39 Median $64.57 Typical High $131.83 | Professional | None | $22.39 | $64.57 | $131.83 |
2 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 55 · Aftercare only Typical Low $6.46 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $6.46 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.37 | $5.75 | $5.75 |
Where Vermont sits
The same service costs 2.5 times more in Wyoming than in Florida. 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· 47th of 51
$38.02
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.