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 $354.81 Median $426.58 Typical High $1,949.84 | Professional | None | $354.81 | $426.58 | $1,949.84 |
BCBS Vermont Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $5,623.41 | Professional | None | $1,949.84 | $2,290.87 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $758.58 Typical High $2,691.53 | Professional | None | $436.52 | $758.58 | $2,691.53 |
MVP Health Care Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,890.45 | Professional | None | $2,137.96 | $2,511.89 | $3,890.45 |
United Setting Professional Modifier None Typical Low $436.52 Median $1,584.89 Typical High $3,981.07 | Professional | None | $436.52 | $1,584.89 | $3,981.07 |
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 $186.21 Median $213.80 Typical High $977.24 | Professional | 52 · Reduced service | $186.21 | $213.80 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $389.05 | Professional | 53 · Discontinued | $75.86 | $85.11 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $316.23 Typical High $1,479.11 | Professional | 54 · Surgery only | $281.84 | $316.23 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $295.12 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $194.98 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $194.98 |
Where Vermont sits
The same service costs 5.6 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· 14th of 51
$1,622
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.