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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $83.18 | Professional | None | $47.86 | $64.57 | $83.18 |
BCBS Vermont Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $114.82 | Professional | None | $91.20 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $83.18 | Professional | None | $47.86 | $69.18 | $83.18 |
MVP Health Care Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $114.82 | Professional | None | $77.62 | $89.13 | $114.82 |
United Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $107.15 | Professional | None | $57.54 | $72.44 | $107.15 |
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 $23.99 Median $27.54 Typical High $34.67 | Professional | 52 · Reduced service | $23.99 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $7.24 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.50 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.79 | $5.50 | $7.08 |
Where Vermont sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 17th of 51
$74.13
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.