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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $144.54 | Professional | None | $56.23 | $77.62 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $144.54 | Professional | None | $67.61 | $120.23 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $87.10 | Facility | None | $34.67 | $34.67 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $131.83 Typical High $354.81 | Professional | None | $60.26 | $131.83 | $354.81 |
Highmark BCBS Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Highmark BCBS Setting Professional Modifier None Typical Low $87.10 Median $186.21 Typical High $204.17 | Professional | None | $87.10 | $186.21 | $204.17 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $562.34 | Facility | None | $100.00 | $131.83 | $562.34 |
United Setting Professional Modifier None Typical Low $54.95 Median $104.71 Typical High $234.42 | Professional | None | $54.95 | $104.71 | $234.42 |
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 $28.18 Median $29.51 Typical High $63.10 | Professional | 52 · Reduced service | $28.18 | $29.51 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $25.12 | Professional | 53 · Discontinued | $11.22 | $11.75 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $44.67 Typical High $93.33 | Professional | 54 · Surgery only | $42.66 | $44.67 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $18.62 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.89 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.62 | $5.89 | $12.59 |
Where West Virginia sits
The same service costs 3.5 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· 34th of 51
$115
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.