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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.92 Typical High $53.70 | Professional | None | $26.30 | $26.92 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $43.65 Typical High $102.33 | Facility | None | $34.67 | $43.65 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $57.54 Typical High $141.25 | Professional | None | $28.18 | $57.54 | $141.25 |
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 $27.54 Median $51.29 Typical High $120.23 | Professional | None | $27.54 | $51.29 | $120.23 |
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 $13.18 Median $13.49 Typical High $26.92 | Professional | 52 · Reduced service | $13.18 | $13.49 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.37 Typical High $10.72 | Professional | 53 · Discontinued | $5.25 | $5.37 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $19.95 Typical High $39.81 | Professional | 54 · Surgery only | $19.50 | $19.95 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.98 Typical High $7.94 | Professional | 55 · Aftercare only | $3.89 | $3.98 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.69 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.63 | $2.69 | $5.37 |
Where West Virginia sits
The same service costs 3.3 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.
West Virginia· 33rd of 51
$53.70
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.