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 $281.84 Median $316.23 Typical High $1,513.56 | Professional | None | $281.84 | $316.23 | $1,513.56 |
BCBS Vermont Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $4,570.88 | Professional | None | $1,513.56 | $1,513.56 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $2,290.87 | Professional | None | $346.74 | $602.56 | $2,290.87 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $3,388.44 | Professional | None | $269.15 | $269.15 | $3,388.44 |
United Setting Professional Modifier None Typical Low $323.59 Median $1,380.38 Typical High $3,311.31 | Professional | None | $323.59 | $1,380.38 | $3,311.31 |
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 $154.88 Median $154.88 Typical High $758.58 | Professional | 52 · Reduced service | $154.88 | $154.88 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $309.03 | Professional | 53 · Discontinued | $61.66 | $63.10 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $234.42 Typical High $1,148.15 | Professional | 54 · Surgery only | $229.09 | $234.42 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $229.09 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $151.36 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $151.36 |
Where Vermont sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 7th of 51
$1,380
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.