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 $29.51 Median $38.02 Typical High $64.57 | Professional | None | $29.51 | $38.02 | $64.57 |
CareSource Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $44.67 | Facility | None | $34.67 | $34.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $67.61 Typical High $181.97 | Professional | None | $30.90 | $67.61 | $181.97 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $457.09 | Facility | None | $100.00 | $131.83 | $457.09 |
United Setting Professional Modifier None Typical Low $30.20 Median $69.18 Typical High $173.78 | Professional | None | $30.20 | $69.18 | $173.78 |
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 $14.79 Median $15.14 Typical High $32.36 | Professional | 52 · Reduced service | $14.79 | $15.14 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.03 Typical High $12.88 | Professional | 53 · Discontinued | $5.89 | $6.03 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.91 Typical High $48.98 | Professional | 54 · Surgery only | $22.39 | $22.91 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $9.77 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $6.46 | Professional | 56 · Pre-op care only | $2.95 | $3.02 | $6.46 |
Where West Virginia sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 41st of 51
$64.57
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.