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 $141.25 Median $223.87 Typical High $331.13 | Professional | None | $141.25 | $223.87 | $331.13 |
BCBS Vermont Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $446.68 | Facility | None | $309.03 | $309.03 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $426.58 | Professional | None | $239.88 | $257.04 | $426.58 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $616.60 | Professional | None | $245.47 | $338.84 | $616.60 |
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 $162.18 Median $263.03 Typical High $416.87 | Professional | None | $162.18 | $263.03 | $416.87 |
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 $72.44 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $72.44 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $28.84 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $109.65 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $21.88 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $14.45 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $102.33 | $169.82 | $194.98 |
Where Vermont sits
The same service costs 3.5 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· 23rd of 51
$251
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.