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 $407.38 Median $478.63 Typical High $2,187.76 | Professional | None | $407.38 | $478.63 | $2,187.76 |
BCBS Vermont Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $8,128.31 | Facility | None | $6,309.57 | $6,309.57 | $8,128.31 |
BCBS Vermont Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $7,244.36 | Professional | None | $2,238.72 | $2,238.72 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $831.76 Typical High $3,388.44 | Professional | None | $489.78 | $831.76 | $3,388.44 |
MVP Health Care Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $4,897.79 | Professional | None | $2,454.71 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $489.78 Median $1,995.26 Typical High $5,011.87 | Professional | None | $489.78 | $1,995.26 | $5,011.87 |
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 $208.93 Median $239.88 Typical High $1,096.48 | Professional | 52 · Reduced service | $208.93 | $239.88 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $95.50 Typical High $436.52 | Professional | 53 · Discontinued | $83.18 | $95.50 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $309.03 | $354.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $70.79 Typical High $323.59 | Professional | 55 · Aftercare only | $61.66 | $70.79 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $47.86 Typical High $218.78 | Professional | 56 · Pre-op care only | $41.69 | $47.86 | $218.78 |
Where Vermont sits
The same service costs 6.2 times more in Washington 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· 6th of 51
$2,188
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.