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 $234.42 Median $831.76 Typical High $1,096.48 | Professional | None | $234.42 | $831.76 | $1,096.48 |
BCBS Vermont Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $3,311.31 | Professional | None | $1,023.29 | $1,023.29 | $3,311.31 |
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 $331.13 Median $426.58 Typical High $1,479.11 | Professional | None | $331.13 | $426.58 | $1,479.11 |
MVP Health Care Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,290.87 | Professional | None | $912.01 | $1,230.27 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Professional Modifier None Typical Low $281.84 Median $870.96 Typical High $1,584.89 | Professional | None | $281.84 | $870.96 | $1,584.89 |
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 $117.49 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $117.49 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $46.77 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $173.78 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $34.67 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $23.44 | $93.33 | $100.00 |
Where Vermont sits
The same service costs 5.4 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· 8th of 51
$977
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.