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 $331.13 Median $338.84 Typical High $1,819.70 | Professional | None | $331.13 | $338.84 | $1,819.70 |
BCBS Vermont Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,786.30 | Professional | None | $1,819.70 | $1,819.70 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $2,511.89 | Professional | None | $389.05 | $676.08 | $2,511.89 |
MVP Health Care Setting Professional Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $3,548.13 | Professional | None | $1,995.26 | $3,090.30 | $3,548.13 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,445.44 Typical High $3,467.37 | Professional | None | $363.08 | $1,445.44 | $3,467.37 |
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 $165.96 Median $169.82 Typical High $912.01 | Professional | 52 · Reduced service | $165.96 | $169.82 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $363.08 | Professional | 53 · Discontinued | $67.61 | $67.61 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $1,380.38 | Professional | 54 · Surgery only | $251.19 | $257.04 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $275.42 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $181.97 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $181.97 |
Where Vermont sits
The same service costs 4.7 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· 4th of 51
$1,660
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.