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 $123.03 Median $147.91 Typical High $186.21 | Professional | None | $123.03 | $147.91 | $186.21 |
BCBS Vermont Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
BCBS Vermont Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $245.47 | Professional | None | $194.98 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $190.55 | Professional | None | $134.90 | $165.96 | $190.55 |
MVP Health Care Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $257.04 | Professional | None | $169.82 | $194.98 | $257.04 |
United Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $229.09 | Professional | None | $144.54 | $181.97 | $229.09 |
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 $61.66 Median $66.07 Typical High $77.62 | Professional | 52 · Reduced service | $61.66 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $23.44 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.18 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.30 | $13.18 | $15.49 |
Where Vermont sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 18th 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.