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 Professional Modifier None Typical Low $31.62 Median $37.15 Typical High $52.48 | Professional | None | $31.62 | $37.15 | $52.48 |
CareSource Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $47.86 | Facility | None | $34.67 | $34.67 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $141.25 | Professional | None | $41.69 | $79.43 | $141.25 |
United Setting Facility Modifier None Typical Low $81.28 Median $131.83 Typical High $457.09 | Facility | None | $81.28 | $131.83 | $457.09 |
United Setting Professional Modifier None Typical Low $26.30 Median $47.86 Typical High $89.13 | Professional | None | $26.30 | $47.86 | $89.13 |
4 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 $15.85 Median $18.62 Typical High $26.30 | Professional | 52 · Reduced service | $15.85 | $18.62 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $7.41 Typical High $10.47 | Professional | 53 · Discontinued | $6.31 | $7.41 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.62 Typical High $7.94 | Professional | 55 · Aftercare only | $4.79 | $5.62 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.72 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.16 | $3.72 | $5.25 |
Where West Virginia sits
The same service costs 3.6 times more in Alaska than in Virginia. 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
$52.48
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.