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 $85.11 Median $165.96 Typical High $275.42 | Professional | None | $85.11 | $165.96 | $275.42 |
BCBS Vermont Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $831.76 | Professional | None | $302.00 | $309.03 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $1,148.15 | Facility | None | $309.03 | $309.03 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $380.19 | Professional | None | $138.04 | $190.55 | $380.19 |
MVP Health Care Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $524.81 | Professional | None | $229.09 | $245.47 | $524.81 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $389.05 | Professional | None | $104.71 | $204.17 | $389.05 |
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 $43.65 Median $89.13 Typical High $100.00 | Professional | 52 · Reduced service | $43.65 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $17.38 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $134.90 Typical High $151.36 | Professional | 54 · Surgery only | $64.57 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $26.92 Typical High $30.20 | Professional | 55 · Aftercare only | $12.88 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $17.78 Typical High $20.42 | Professional | 56 · Pre-op care only | $8.71 | $17.78 | $20.42 |
Where Vermont sits
The same service costs 4.1 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· 24th 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.