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 $53.70 Median $104.71 Typical High $165.96 | Professional | None | $53.70 | $104.71 | $165.96 |
BCBS Vermont Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $467.74 | Professional | None | $173.78 | $173.78 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $309.03 | Facility | None | $263.03 | $263.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $223.87 | Professional | None | $83.18 | $114.82 | $223.87 |
MVP Health Care Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $316.23 | Professional | None | $131.83 | $173.78 | $316.23 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
United Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $204.17 | Professional | None | $53.70 | $102.33 | $204.17 |
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 $27.54 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $27.54 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $11.22 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $41.69 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $8.32 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $12.30 Typical High $14.13 | Professional | 56 · Pre-op care only | $5.62 | $12.30 | $14.13 |
Where Vermont sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 18th of 51
$126
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.