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 $42.66 Median $74.13 Typical High $123.03 | Professional | None | $42.66 | $74.13 | $123.03 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $100.00 Typical High $120.23 | Professional | None | $51.29 | $100.00 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $64.57 Typical High $229.09 | Facility | None | $34.67 | $64.57 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $109.65 Typical High $281.84 | Professional | None | $45.71 | $109.65 | $281.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $380.19 | Facility | None | $363.08 | $363.08 | $380.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $151.36 | Professional | None | $77.62 | $95.50 | $151.36 |
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 $38.90 Median $83.18 Typical High $177.83 | Professional | None | $38.90 | $83.18 | $177.83 |
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 $21.38 Median $22.91 Typical High $52.48 | Professional | 52 · Reduced service | $21.38 | $22.91 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $20.89 | Professional | 53 · Discontinued | $8.71 | $9.12 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $33.88 Typical High $79.43 | Professional | 54 · Surgery only | $32.36 | $33.88 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.76 Typical High $15.85 | Professional | 55 · Aftercare only | $6.46 | $6.76 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.37 | $4.57 | $10.47 |
Where West Virginia sits
The same service costs 3.5 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· 26th of 51
$95.50
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.