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 Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $169.82 | Professional | None | $43.65 | $48.98 | $169.82 |
BCBS Vermont 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 |
BCBS Vermont Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $676.08 | Professional | None | $251.19 | $251.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $302.00 | Professional | None | $61.66 | $109.65 | $302.00 |
MVP Health Care Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $416.87 | Professional | None | $50.12 | $50.12 | $416.87 |
United Setting Professional Modifier None Typical Low $51.29 Median $173.78 Typical High $467.74 | Professional | None | $51.29 | $173.78 | $467.74 |
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 $21.88 Median $24.55 Typical High $85.11 | Professional | 52 · Reduced service | $21.88 | $24.55 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.77 Typical High $33.88 | Professional | 53 · Discontinued | $8.71 | $9.77 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $36.31 Typical High $125.89 | Professional | 54 · Surgery only | $33.11 | $36.31 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.24 Typical High $25.70 | Professional | 55 · Aftercare only | $6.61 | $7.24 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.90 Typical High $16.98 | Professional | 56 · Pre-op care only | $4.37 | $4.90 | $16.98 |
Where Vermont sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 16th of 51
$170
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.