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 $64.57 Median $77.62 Typical High $91.20 | Professional | None | $64.57 | $77.62 | $91.20 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $102.33 Typical High $151.36 | Facility | None | $34.67 | $102.33 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $128.82 Typical High $229.09 | Professional | None | $75.86 | $128.82 | $229.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | None | $134.90 | $134.90 | $141.25 |
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 $53.70 Median $81.28 Typical High $162.18 | Professional | None | $53.70 | $81.28 | $162.18 |
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 $32.36 Median $37.15 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.14 Typical High $16.60 | Professional | 53 · Discontinued | $12.88 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $56.23 Typical High $63.10 | Professional | 54 · Surgery only | $47.86 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $12.59 | Professional | 55 · Aftercare only | $9.77 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.41 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.46 | $7.41 | $8.32 |
Where West Virginia sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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
$95.50
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.