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 $134.90 Median $239.88 Typical High $398.11 | Professional | None | $134.90 | $239.88 | $398.11 |
BCBS Vermont Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $1,148.15 | Professional | None | $323.59 | $323.59 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $3,162.28 | Facility | None | $309.03 | $309.03 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $537.03 | Professional | None | $239.88 | $269.15 | $537.03 |
MVP Health Care Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $758.58 | Professional | None | $323.59 | $371.54 | $758.58 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
United Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $549.54 | Professional | None | $158.49 | $281.84 | $549.54 |
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 $70.79 Median $131.83 Typical High $154.88 | Professional | 52 · Reduced service | $70.79 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $52.48 Typical High $61.66 | Professional | 53 · Discontinued | $28.18 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $199.53 Typical High $229.09 | Professional | 54 · Surgery only | $104.71 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $39.81 Typical High $45.71 | Professional | 55 · Aftercare only | $20.89 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $26.30 Typical High $30.90 | Professional | 56 · Pre-op care only | $14.13 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $186.21 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $97.72 | $186.21 | $213.80 |
Where Vermont sits
The same service costs 3.6 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· 31st of 51
$275
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.