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 $72.44 Median $151.36 Typical High $208.93 | Professional | None | $72.44 | $151.36 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $114.82 | Facility | None | $34.67 | $34.67 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $1,202.26 | Professional | None | $104.71 | $223.87 | $1,202.26 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $371.54 | Professional | None | $72.44 | $158.49 | $371.54 |
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 $36.31 Median $37.15 Typical High $75.86 | Professional | 52 · Reduced service | $36.31 | $37.15 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $30.20 | Professional | 53 · Discontinued | $14.45 | $15.14 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $56.23 Typical High $112.20 | Professional | 54 · Surgery only | $53.70 | $56.23 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $22.39 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $15.14 |
Where West Virginia sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 16th of 51
$174
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.