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 $338.84 Median $1,412.54 Typical High $1,659.59 | Professional | None | $338.84 | $1,412.54 | $1,659.59 |
BCBS Vermont Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $4,365.16 | Professional | None | $1,621.81 | $1,621.81 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $3,890.45 | Facility | None | $467.74 | $467.74 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $1,949.84 | Professional | None | $436.52 | $588.84 | $1,949.84 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,288.25 | $1,905.46 | $3,311.31 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,230.27 Typical High $2,089.30 | Professional | None | $380.19 | $1,230.27 | $2,089.30 |
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 $165.96 Median $707.95 Typical High $758.58 | Professional | 52 · Reduced service | $165.96 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $281.84 Typical High $309.03 | Professional | 53 · Discontinued | $67.61 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $1,071.52 Typical High $1,148.15 | Professional | 54 · Surgery only | $251.19 | $1,071.52 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $213.80 Typical High $229.09 | Professional | 55 · Aftercare only | $50.12 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $141.25 Typical High $151.36 | Professional | 56 · Pre-op care only | $33.88 | $141.25 | $151.36 |
Where Vermont sits
The same service costs 6.0 times more in Iowa 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· 9th of 51
$1,413
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.