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 $69.18 Median $79.43 Typical High $144.54 | Professional | None | $69.18 | $79.43 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $398.11 Typical High $1,995.26 | Facility | None | $109.65 | $398.11 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $204.17 Typical High $794.33 | Professional | None | $87.10 | $204.17 | $794.33 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $4,570.88 | Facility | None | $426.58 | $660.69 | $4,570.88 |
United Setting Professional Modifier None Typical Low $58.88 Median $123.03 Typical High $302.00 | Professional | None | $58.88 | $123.03 | $302.00 |
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 $34.67 Median $39.81 Typical High $72.44 | Professional | 52 · Reduced service | $34.67 | $39.81 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.85 Typical High $28.84 | Professional | 53 · Discontinued | $13.80 | $15.85 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $58.88 Typical High $107.15 | Professional | 54 · Surgery only | $51.29 | $58.88 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $21.38 | Professional | 55 · Aftercare only | $10.23 | $11.75 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.94 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.92 | $7.94 | $14.45 |
Where West Virginia sits
The same service costs 4.9 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
$141
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.