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 $173.78 Median $190.55 Typical High $812.83 | Professional | None | $173.78 | $190.55 | $812.83 |
BCBS Vermont Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,041.74 | Facility | None | $1,584.89 | $1,584.89 | $2,041.74 |
BCBS Vermont Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $2,187.76 | Professional | None | $776.25 | $776.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $1,023.29 | Professional | None | $213.80 | $371.54 | $1,023.29 |
MVP Health Care Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $1,479.11 | Professional | None | $204.17 | $204.17 | $1,479.11 |
United Setting Professional Modifier None Typical Low $190.55 Median $602.56 Typical High $1,513.56 | Professional | None | $190.55 | $602.56 | $1,513.56 |
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 $91.20 Median $95.50 Typical High $407.38 | Professional | 52 · Reduced service | $91.20 | $95.50 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.02 Typical High $162.18 | Professional | 53 · Discontinued | $37.15 | $38.02 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $144.54 Typical High $616.60 | Professional | 54 · Surgery only | $138.04 | $144.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $123.03 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.05 Typical High $81.28 | Professional | 56 · Pre-op care only | $18.62 | $19.05 | $81.28 |
Where Vermont sits
The same service costs 3.8 times more in Wisconsin than in Nebraska. 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· 8th of 51
$676
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.