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 $79.43 Median $204.17 Typical High $204.17 | Facility | None | $79.43 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $177.83 Typical High $269.15 | Professional | None | $72.44 | $177.83 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $109.65 | Facility | None | $34.67 | $34.67 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $213.80 Typical High $2,630.27 | Professional | None | $95.50 | $213.80 | $2,630.27 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,230.27 | $2,511.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | None | $123.03 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $70.79 Median $165.96 Typical High $380.19 | Professional | None | $70.79 | $165.96 | $380.19 |
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 $35.48 Median $38.02 Typical High $93.33 | Professional | 52 · Reduced service | $35.48 | $38.02 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $37.15 | Professional | 53 · Discontinued | $14.45 | $15.14 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $56.23 Typical High $141.25 | Professional | 54 · Surgery only | $53.70 | $56.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $28.18 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $18.62 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $18.62 |
Where West Virginia sits
The same service costs 3.8 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· 15th of 51
$191
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.