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 $79.43 Median $537.03 Typical High $707.95 | Professional | None | $79.43 | $537.03 | $707.95 |
BCBS Vermont Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $2,187.76 | Professional | None | $870.96 | $870.96 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,995.26 | Facility | None | $467.74 | $467.74 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $977.24 | Professional | None | $117.49 | $190.55 | $977.24 |
MVP Health Care Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,548.82 | Professional | None | $616.60 | $776.25 | $1,548.82 |
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 $97.72 Median $588.84 Typical High $1,047.13 | Professional | None | $97.72 | $588.84 | $1,047.13 |
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 $39.81 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $39.81 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $15.85 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $58.88 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $12.02 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $7.94 | $58.88 | $63.10 |
Where Vermont sits
The same service costs 8.9 times more in Iowa than in Washington, DC. 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· 10th of 51
$617
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.