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 $16.22 Median $16.22 Typical High $28.18 | Professional | None | $16.22 | $16.22 | $28.18 |
CareSource Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Facility | None | $25.70 | $25.70 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $28.84 Typical High $123.03 | Professional | None | $16.60 | $28.84 | $123.03 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $457.09 | Facility | None | $100.00 | $131.83 | $457.09 |
United Setting Professional Modifier None Typical Low $16.60 Median $37.15 Typical High $102.33 | Professional | None | $16.60 | $37.15 | $102.33 |
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 $8.13 Median $12.88 Typical High $14.13 | Professional | 52 · Reduced service | $8.13 | $12.88 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $5.25 Typical High $5.62 | Professional | 53 · Discontinued | $3.24 | $5.25 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.02 Median $12.02 Typical High $21.38 | Professional | 54 · Surgery only | $12.02 | $12.02 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.89 Typical High $4.27 | Professional | 55 · Aftercare only | $2.45 | $3.89 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.57 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.62 | $2.57 | $2.82 |
Where West Virginia sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 42nd of 51
$28.84
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.