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 $57.54 Median $102.33 Typical High $102.33 | Facility | None | $57.54 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $102.33 | Professional | None | $52.48 | $63.10 | $102.33 |
CareSource Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $83.18 Typical High $173.78 | Facility | None | $34.67 | $83.18 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $144.54 Typical High $549.54 | Professional | None | $66.07 | $144.54 | $549.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $758.58 Median $1,096.48 Typical High $2,041.74 | Facility | None | $758.58 | $1,096.48 | $2,041.74 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $1,148.15 | Facility | None | $100.00 | $131.83 | $1,148.15 |
United Setting Professional Modifier None Typical Low $51.29 Median $107.15 Typical High $302.00 | Professional | None | $51.29 | $107.15 | $302.00 |
5 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 $26.30 Median $31.62 Typical High $46.77 | Professional | 52 · Reduced service | $26.30 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $12.59 Typical High $18.62 | Professional | 53 · Discontinued | $10.47 | $12.59 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $46.77 Typical High $69.18 | Professional | 54 · Surgery only | $38.90 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.55 Typical High $14.13 | Professional | 55 · Aftercare only | $7.76 | $9.55 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.31 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.25 | $6.31 | $9.33 |
Where West Virginia sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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.
West Virginia· 40th of 51
$102
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.