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 $257.04 Median $269.15 Typical High $1,445.44 | Professional | None | $257.04 | $269.15 | $1,445.44 |
BCBS Vermont Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,168.69 | Facility | None | $3,235.94 | $3,235.94 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $1,949.84 | Professional | None | $295.12 | $524.81 | $1,949.84 |
MVP Health Care Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,905.46 | $2,630.27 |
United Setting Professional Modifier None Typical Low $275.42 Median $1,096.48 Typical High $2,570.40 | Professional | None | $275.42 | $1,096.48 | $2,570.40 |
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 $128.82 Median $134.90 Typical High $724.44 | Professional | 52 · Reduced service | $128.82 | $134.90 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $288.40 | Professional | 53 · Discontinued | $51.29 | $53.70 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $1,096.48 | Professional | 54 · Surgery only | $190.55 | $199.53 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $39.81 Typical High $218.78 | Professional | 55 · Aftercare only | $38.90 | $39.81 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $144.54 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $144.54 |
Where Vermont sits
The same service costs 5.9 times more in Wisconsin than in Maryland. 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
$1,202
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.