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 $60.26 Median $67.61 Typical High $131.83 | Professional | None | $60.26 | $67.61 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $93.33 Typical High $245.47 | Facility | None | $34.67 | $93.33 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $131.83 Typical High $363.08 | Professional | None | $63.10 | $131.83 | $363.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $186.21 | Professional | None | $169.82 | $177.83 | $186.21 |
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 $60.26 Median $107.15 Typical High $245.47 | Professional | None | $60.26 | $107.15 | $245.47 |
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 $30.20 Median $30.90 Typical High $64.57 | Professional | 52 · Reduced service | $30.20 | $30.90 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $25.70 | Professional | 53 · Discontinued | $12.02 | $12.30 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $46.77 Typical High $95.50 | Professional | 54 · Surgery only | $44.67 | $46.77 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $19.05 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $12.88 |
Where West Virginia sits
The same service costs 3.1 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· 29th of 51
$120
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.