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 $75.86 Median $93.33 Typical High $204.17 | Professional | None | $75.86 | $93.33 | $204.17 |
BCBS Vermont Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $812.83 | Facility | None | $758.58 | $758.58 | $812.83 |
BCBS Vermont Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $724.44 | Professional | None | $446.68 | $446.68 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $346.74 | Professional | None | $120.23 | $223.87 | $346.74 |
MVP Health Care Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $457.09 | Professional | None | $93.33 | $93.33 | $457.09 |
United Setting Professional Modifier None Typical Low $95.50 Median $234.42 Typical High $501.19 | Professional | None | $95.50 | $234.42 | $501.19 |
5 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 $42.66 Median $46.77 Typical High $102.33 | Professional | 52 · Reduced service | $42.66 | $46.77 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $40.74 | Professional | 53 · Discontinued | $17.38 | $18.62 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $69.18 Typical High $154.88 | Professional | 54 · Surgery only | $64.57 | $69.18 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.80 Typical High $30.90 | Professional | 55 · Aftercare only | $12.88 | $13.80 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $20.42 | Professional | 56 · Pre-op care only | $8.71 | $9.33 | $20.42 |
Where Vermont sits
The same service costs 3.8 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· 13th of 51
$204
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.