What is the top of the local market (P90) for CPT 20610 under Premera Ak for Burlington-South Burlington, VT providers?

The P90, the top of the local market and Reddenda's target rate, is $232.59.

How does Premera Ak's rate for CPT 20610 compare to Medicare?

The Premera Ak local median of $109.73 is 159% of Medicare's national non-facility rate of $68.81 for CPT 20610.

Reddenda · Rate Intelligence · Burlington-South Burlington, VT

20610 under Premera Ak, for Burlington-South Burlington, VT providers

Name: Premera Ak rates for CPT 20610 among Burlington-South Burlington, VT providers
Creator: Reddenda

Major joint injection (shoulder, hip, knee) · Local peer median $109.73 · High confidence

$109.73 local peer median. Premera Ak's published rate file lists a local peer median of $109.73 for CPT 20610 (Major joint injection (shoulder, hip, knee)) among 216 indexed providers in Burlington-South Burlington, VT. Where a Blue Cross entity’s label carries a state, that state names the file we found the rate in, not the provider’s location. Blue Cross plans file separately per state and do not share rates, even for the same provider. The top of that filed distribution, the P90 target, is $232.59, 112% above the median. A provider billed below this median is being paid less than peers holding the identical Premera Ak contract for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 216 providers · 216 rate records

P10

$93.09

P25

$93.09

Median

$109.73

P75

$232.59

P90 (target)

$232.59

P10$93.09

P25$93.09

Median (P50)$109.73

P75$232.59

P90 target$232.59

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $77.50 – $232.59

The local peer median for CPT 20610 under Premera Ak for Burlington-South Burlington, VT providers is $109.73, drawn from 216 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Premera Ak to publish this rate
The bottom of the local market (P10) is $93.09 and the top (P90) is $232.59; the median-to-P90 spread is $122.86.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Premera Ak to publish this rate
The lowest published rate in this market is $77.50; the highest is $232.59.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Premera Ak to publish this rate
This benchmark is drawn from 216 individual rate records that Premera Ak itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Premera Ak to publish this rate
Medicare's national non-facility rate for CPT 20610 is $68.81, making the Premera Ak local median 159% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Premera Ak to publish this rate
39.4% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Premera Ak to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

216 providers bill this code to this payer in this metro.

Find yourself on this curve. Enter your NPI: no account, no email, no PHI.

Free, forever, unmetered. Possession-channel verification only if you choose to claim the record; looking is always free.

See where your rate lands

These are the rates Premera Ak publishes for CPT 20610 (Major joint injection (shoulder, hip, knee)) among Burlington-South Burlington, VT providers. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

Run a free RateScore on your NPI → Talk to us about Premera Ak

Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Premera Ak's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Premera Ak to publish this rate. Page generated 2026-08-23 23:41 UTC; the live index is queried in real time on every request.