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 $1,000.00 Typical High $1,584.89 | Professional | None | $134.90 | $1,000.00 | $1,584.89 |
BCBS Vermont Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,786.30 | Professional | None | $1,348.96 | $1,348.96 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,659.59 | Facility | None | $467.74 | $467.74 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $2,089.30 | Professional | None | $199.53 | $288.40 | $2,089.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,412.54 | $3,090.30 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
United Setting Professional Modifier None Typical Low $169.82 Median $1,148.15 Typical High $2,089.30 | Professional | None | $169.82 | $1,148.15 | $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 $67.61 Median $537.03 Typical High $575.44 | Professional | 52 · Reduced service | $67.61 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $213.80 Typical High $229.09 | Professional | 53 · Discontinued | $26.92 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $102.33 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $20.42 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $107.15 Typical High $114.82 | Professional | 56 · Pre-op care only | $13.49 | $107.15 | $114.82 |
Where Vermont sits
The same service costs 11.7 times more in Washington 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
$1,122
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.