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 $58.88 Median $154.88 Typical High $154.88 | Facility | None | $58.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $154.88 | Professional | None | $53.70 | $70.79 | $154.88 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $83.18 Typical High $309.03 | Facility | None | $34.67 | $83.18 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $147.91 Typical High $380.19 | Professional | None | $57.54 | $147.91 | $380.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $2,041.74 | Facility | None | $151.36 | $436.52 | $2,041.74 |
United Setting Professional Modifier None Typical Low $56.23 Median $144.54 Typical High $363.08 | Professional | None | $56.23 | $144.54 | $363.08 |
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 $26.92 Median $28.18 Typical High $70.79 | Professional | 52 · Reduced service | $26.92 | $28.18 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.22 Typical High $28.18 | Professional | 53 · Discontinued | $10.72 | $11.22 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $41.69 Typical High $104.71 | Professional | 54 · Surgery only | $40.74 | $41.69 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $21.38 | Professional | 55 · Aftercare only | $8.13 | $8.32 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.62 Typical High $14.13 | Professional | 56 · Pre-op care only | $5.37 | $5.62 | $14.13 |
Where West Virginia sits
The same service costs 2.6 times more in Alaska than in Montana. 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
$141
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.