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 $66.07 Median $91.20 Typical High $141.25 | Professional | None | $66.07 | $91.20 | $141.25 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $102.33 | Facility | None | $34.67 | $34.67 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $144.54 Typical High $398.11 | Professional | None | $72.44 | $144.54 | $398.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $64.57 Median $120.23 Typical High $275.42 | Professional | None | $64.57 | $120.23 | $275.42 |
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 $33.11 Median $35.48 Typical High $69.18 | Professional | 52 · Reduced service | $33.11 | $35.48 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.13 Typical High $27.54 | Professional | 53 · Discontinued | $13.18 | $14.13 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $52.48 Typical High $104.71 | Professional | 54 · Surgery only | $50.12 | $52.48 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.47 Typical High $20.89 | Professional | 55 · Aftercare only | $10.00 | $10.47 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.08 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.61 | $7.08 | $13.80 |
Where West Virginia sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 30th of 51
$132
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.