How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $28.84 Median $77.62 Typical High $144.54 | Professional | None | $28.84 | $77.62 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $15.49 Typical High $28.84 | Professional | 53 · Discontinued | $5.75 | $15.49 | $28.84 |
BCBS Vermont Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $128.82 Typical High $204.17 | Professional | None | $70.79 | $128.82 | $204.17 |
MVP Health Care Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $331.13 | Professional | None | $158.49 | $169.82 | $331.13 |
United Setting Professional Modifier None Typical Low $53.70 Median $123.03 Typical High $199.53 | Professional | None | $53.70 | $123.03 | $199.53 |
3 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 $14.13 Median $38.90 Typical High $72.44 | Professional | 52 · Reduced service | $14.13 | $38.90 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $11.75 Typical High $21.88 | Professional | 55 · Aftercare only | $4.27 | $11.75 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $7.76 Typical High $14.45 | Professional | 56 · Pre-op care only | $2.82 | $7.76 | $14.45 |
Where Vermont sits
The same service costs 3.5 times more in Wisconsin 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· 30th of 51
$115
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.