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 $275.42 Median $1,174.90 Typical High $1,412.54 | Professional | None | $275.42 | $1,174.90 | $1,412.54 |
BCBS Vermont Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $3,548.13 | Professional | None | $1,445.44 | $1,698.24 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $1,995.26 | Facility | None | $309.03 | $309.03 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $1,621.81 | Professional | None | $407.38 | $489.78 | $1,621.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,659.59 | $2,754.23 |
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 $331.13 Median $1,023.29 Typical High $1,819.70 | Professional | None | $331.13 | $1,023.29 | $1,819.70 |
2 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 54 · Surgery only Typical Low $204.17 Median $891.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $204.17 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $831.76 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $190.55 | $831.76 | $933.25 |
Where Vermont sits
The same service costs 5.6 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· 10th of 51
$1,230
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.