How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $48.98 Median $69.18 Typical High $1,412.54 | Facility | None | $48.98 | $69.18 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $87.10 | Professional | None | $44.67 | $61.66 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $60.26 Typical High $100.00 | Professional | None | $52.48 | $60.26 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $104.71 | Facility | None | $34.67 | $70.79 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $165.96 | Professional | None | $56.23 | $95.50 | $165.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,621.81 | Facility | None | $223.87 | $707.95 | $1,621.81 |
Highmark BCBS Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $114.82 | Professional | None | $63.10 | $95.50 | $114.82 |
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 $37.15 Median $63.10 Typical High $123.03 | Professional | None | $37.15 | $63.10 | $123.03 |
6 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 $22.39 Median $25.70 Typical High $30.90 | Professional | 52 · Reduced service | $22.39 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $10.23 Typical High $12.59 | Professional | 53 · Discontinued | $8.91 | $10.23 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $38.90 Typical High $46.77 | Professional | 54 · Surgery only | $33.88 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.76 Typical High $9.33 | Professional | 55 · Aftercare only | $6.76 | $7.76 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.13 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.47 | $5.13 | $6.17 |
Highmark BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $151.36 Typical High $165.96 | Professional | 50 · Both sides | $104.71 | $151.36 | $165.96 |
Where West Virginia sits
The same service costs 4.2 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· 35th of 51
$69.18
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.