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 Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $162.18 | Professional | None | $40.74 | $75.86 | $162.18 |
BCBS Vermont Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $524.81 | Facility | None | $436.52 | $436.52 | $524.81 |
BCBS Vermont Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | None | $123.03 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $199.53 | Professional | None | $72.44 | $117.49 | $199.53 |
MVP Health Care Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $269.15 | Professional | None | $120.23 | $123.03 | $269.15 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $177.83 | Professional | None | $46.77 | $100.00 | $177.83 |
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 $20.89 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $20.89 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $8.32 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $66.07 Typical High $75.86 | Professional | 54 · Surgery only | $31.62 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $6.31 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.17 | $8.91 | $10.23 |
Where Vermont sits
The same service costs 3.4 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· 13th of 51
$117
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.