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 $194.98 Median $269.15 Typical High $398.11 | Professional | None | $194.98 | $269.15 | $398.11 |
BCBS Vermont Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
BCBS Vermont Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | None | $295.12 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $537.03 | Facility | None | $309.03 | $309.03 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $501.19 | Professional | None | $263.03 | $338.84 | $501.19 |
MVP Health Care Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $707.95 | Professional | None | $288.40 | $371.54 | $707.95 |
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 $218.78 Median $295.12 Typical High $501.19 | Professional | None | $218.78 | $295.12 | $501.19 |
6 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 $97.72 Median $131.83 Typical High $154.88 | Professional | 52 · Reduced service | $97.72 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $39.81 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $199.53 Typical High $229.09 | Professional | 54 · Surgery only | $147.91 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $39.81 Typical High $45.71 | Professional | 55 · Aftercare only | $29.51 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.30 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.50 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $186.21 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $138.04 | $186.21 | $213.80 |
Where Vermont sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 17th of 51
$339
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.