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 $83.18 Median $154.88 Typical High $275.42 | Professional | None | $83.18 | $154.88 | $275.42 |
BCBS Vermont Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $616.60 | Professional | None | $263.03 | $263.03 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $346.74 | Professional | None | $109.65 | $204.17 | $346.74 |
MVP Health Care Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $616.60 | Professional | None | $173.78 | $281.84 | $616.60 |
United Setting Professional Modifier None Typical Low $77.62 Median $194.98 Typical High $398.11 | Professional | None | $77.62 | $194.98 | $398.11 |
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 $45.71 Median $77.62 Typical High $138.04 | Professional | 52 · Reduced service | $45.71 | $77.62 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $30.90 Typical High $54.95 | Professional | 53 · Discontinued | $18.62 | $30.90 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $114.82 Typical High $204.17 | Professional | 54 · Surgery only | $69.18 | $114.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $22.91 Typical High $40.74 | Professional | 55 · Aftercare only | $13.80 | $22.91 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $15.49 Typical High $27.54 | Professional | 56 · Pre-op care only | $9.12 | $15.49 | $27.54 |
Where Vermont sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 15th of 51
$195
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.