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 $144.54 Median $489.78 Typical High $602.56 | Professional | None | $144.54 | $489.78 | $602.56 |
BCBS Vermont Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,862.09 | Professional | None | $630.96 | $630.96 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $831.76 | Professional | None | $223.87 | $398.11 | $831.76 |
MVP Health Care Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,348.96 | Professional | None | $537.03 | $724.44 | $1,348.96 |
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 $181.97 Median $562.34 Typical High $891.25 | Professional | None | $181.97 | $562.34 | $891.25 |
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 $74.13 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $74.13 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $29.51 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $112.20 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $22.39 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $14.79 | $53.70 | $60.26 |
Where Vermont sits
The same service costs 4.9 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
$575
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.