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 $40.74 Median $57.54 Typical High $72.44 | Professional | None | $40.74 | $57.54 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $97.72 | Professional | None | $46.77 | $60.26 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $64.57 Typical High $114.82 | Facility | None | $34.67 | $64.57 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $95.50 Typical High $162.18 | Professional | None | $53.70 | $95.50 | $162.18 |
Highmark BCBS Setting Facility Modifier None Typical Low $79.43 Median $741.31 Typical High $1,348.96 | Facility | None | $79.43 | $741.31 | $1,348.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $147.91 | Professional | None | $87.10 | $95.50 | $147.91 |
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 $33.11 Median $53.70 Typical High $107.15 | Professional | None | $33.11 | $53.70 | $107.15 |
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 $20.42 Median $23.44 Typical High $30.20 | Professional | 52 · Reduced service | $20.42 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $9.33 Typical High $12.30 | Professional | 53 · Discontinued | $8.13 | $9.33 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $35.48 Typical High $45.71 | Professional | 54 · Surgery only | $30.20 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.08 Typical High $9.12 | Professional | 55 · Aftercare only | $6.03 | $7.08 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.68 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.07 | $4.68 | $6.17 |
Where West Virginia sits
The same service costs 3.5 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· 36th of 51
$61.66
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.