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 $128.82 Median $229.09 Typical High $407.38 | Professional | None | $128.82 | $229.09 | $407.38 |
BCBS Vermont Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $1,174.90 | Professional | None | $331.13 | $331.13 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $660.69 | Facility | None | $467.74 | $467.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $549.54 | Professional | None | $251.19 | $323.59 | $549.54 |
MVP Health Care Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $776.25 | Professional | None | $323.59 | $338.84 | $776.25 |
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 $177.83 Median $275.42 Typical High $562.34 | Professional | None | $177.83 | $275.42 | $562.34 |
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 $67.61 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $67.61 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $26.92 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $100.00 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $19.95 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $13.49 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $162.18 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $93.33 | $162.18 | $181.97 |
Where Vermont sits
The same service costs 4.5 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· 21st of 51
$324
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.