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 $69.18 Median $123.03 Typical High $208.93 | Professional | None | $69.18 | $123.03 | $208.93 |
BCBS Vermont Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $630.96 | Professional | None | $251.19 | $251.19 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $467.74 | Facility | None | $323.59 | $323.59 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $288.40 | Professional | None | $109.65 | $165.96 | $288.40 |
MVP Health Care Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $380.19 | Professional | None | $173.78 | $181.97 | $380.19 |
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 $87.10 Median $154.88 Typical High $302.00 | Professional | None | $87.10 | $154.88 | $302.00 |
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 $34.67 Median $66.07 Typical High $74.13 | Professional | 52 · Reduced service | $34.67 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $26.30 Typical High $29.51 | Professional | 53 · Discontinued | $13.80 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $97.72 Typical High $109.65 | Professional | 54 · Surgery only | $52.48 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $10.47 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $13.18 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.92 | $13.18 | $14.79 |
Where Vermont sits
The same service costs 3.7 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· 25th of 51
$148
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.