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 $63.10 Median $87.10 Typical High $87.10 | Facility | None | $63.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $93.33 | Professional | None | $57.54 | $77.62 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $125.89 | Professional | None | $64.57 | $75.86 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $87.10 Typical High $141.25 | Facility | None | $34.67 | $87.10 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $208.93 | Professional | None | $70.79 | $120.23 | $208.93 |
Highmark BCBS Setting Facility Modifier None Typical Low $245.47 Median $549.54 Typical High $1,071.52 | Facility | None | $245.47 | $549.54 | $1,071.52 |
Highmark BCBS Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | None | $117.49 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $851.14 | Facility | None | $100.00 | $131.83 | $851.14 |
United Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $141.25 | Professional | None | $46.77 | $72.44 | $141.25 |
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 $28.18 Median $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $28.18 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $11.48 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $48.98 Typical High $58.88 | Professional | 54 · Surgery only | $42.66 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.77 Typical High $11.75 | Professional | 55 · Aftercare only | $8.51 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.75 | $6.46 | $7.94 |
Where West Virginia sits
The same service costs 3.4 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· 30th of 51
$87.10
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.