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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $134.90 | Professional | None | $91.20 | $91.20 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $144.54 Typical High $213.80 | Facility | None | $34.67 | $144.54 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $371.54 | Professional | None | $97.72 | $144.54 | $371.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,570.40 | Facility | None | $1,548.82 | $1,905.46 | $2,570.40 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $1,995.26 | Facility | None | $151.36 | $436.52 | $1,995.26 |
United Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $338.84 | Professional | None | $89.13 | $144.54 | $338.84 |
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 $45.71 Median $45.71 Typical High $67.61 | Professional | 52 · Reduced service | $45.71 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $26.92 | Professional | 53 · Discontinued | $18.20 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $69.18 Typical High $102.33 | Professional | 54 · Surgery only | $67.61 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $20.42 | Professional | 55 · Aftercare only | $13.49 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $13.49 |
Where West Virginia sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 32nd of 51
$145
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.