How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $95.50 Median $109.65 Typical High $575.44 | Professional | None | $95.50 | $109.65 | $575.44 |
BCBS Vermont Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,584.89 | Professional | None | $457.09 | $457.09 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $724.44 | Professional | None | $120.23 | $204.17 | $724.44 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $954.99 | Professional | None | $309.03 | $309.03 | $954.99 |
United Setting Professional Modifier None Typical Low $100.00 Median $398.11 Typical High $1,096.48 | Professional | None | $100.00 | $398.11 | $1,096.48 |
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 $54.95 Median $54.95 Typical High $213.80 | Professional | 52 · Reduced service | $54.95 | $54.95 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $85.11 | Professional | 53 · Discontinued | $21.88 | $21.88 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $316.23 | Professional | 54 · Surgery only | $81.28 | $81.28 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.60 Typical High $63.10 | Professional | 55 · Aftercare only | $16.22 | $16.60 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $42.66 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $42.66 |
Where Vermont sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 11th of 51
$427
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.