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 $48.98 Median $52.48 Typical High $74.13 | Professional | None | $48.98 | $52.48 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $77.62 Typical High $151.36 | Facility | None | $34.67 | $77.62 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $190.55 | Professional | None | $53.70 | $81.28 | $190.55 |
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 $45.71 Median $75.86 Typical High $165.96 | Professional | None | $45.71 | $75.86 | $165.96 |
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 $24.55 Median $26.30 Typical High $37.15 | Professional | 52 · Reduced service | $24.55 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.47 Typical High $14.79 | Professional | 53 · Discontinued | $9.77 | $10.47 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $39.81 Typical High $54.95 | Professional | 54 · Surgery only | $37.15 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.94 Typical High $10.96 | Professional | 55 · Aftercare only | $7.41 | $7.94 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $7.41 |
Where West Virginia sits
The same service costs 3.4 times more in Alaska than in New York. 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
$77.62
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.