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 $12.88 Median $21.88 Typical High $21.88 | Professional | None | $12.88 | $21.88 | $21.88 |
BCBS Vermont Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $56.23 | Professional | None | $23.44 | $23.44 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
MVP Health Care Setting Professional Modifier None Typical Low $16.22 Median $20.42 Typical High $26.30 | Professional | None | $16.22 | $20.42 | $26.30 |
United Setting Professional Modifier None Typical Low $14.13 Median $21.88 Typical High $26.92 | Professional | None | $14.13 | $21.88 | $26.92 |
4 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 $6.46 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $6.46 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $2.57 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $1.95 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.29 | $2.19 | $2.19 |
Where Vermont sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 21st of 51
$17.78
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.