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 $58.88 Median $81.28 Typical High $138.04 | Professional | None | $58.88 | $81.28 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $144.54 | Professional | None | $70.79 | $120.23 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $91.20 Typical High $251.19 | Facility | None | $34.67 | $91.20 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $131.83 Typical High $288.40 | Professional | None | $63.10 | $131.83 | $288.40 |
Highmark BCBS Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | None | $131.83 | $131.83 | $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 $56.23 Median $102.33 Typical High $229.09 | Professional | None | $56.23 | $102.33 | $229.09 |
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 $29.51 Median $30.90 Typical High $63.10 | Professional | 52 · Reduced service | $29.51 | $30.90 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $25.12 | Professional | 53 · Discontinued | $11.75 | $12.30 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $46.77 Typical High $93.33 | Professional | 54 · Surgery only | $44.67 | $46.77 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $18.62 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.89 | $6.17 | $12.59 |
Where West Virginia sits
The same service costs 3.2 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· 30th 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.