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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $93.33 | Professional | None | $67.61 | $79.43 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $114.82 Typical High $213.80 | Facility | None | $34.67 | $114.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $223.87 | Professional | None | $91.20 | $147.91 | $223.87 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $776.25 | Facility | None | $100.00 | $131.83 | $776.25 |
United Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $154.88 | Professional | None | $52.48 | $83.18 | $154.88 |
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 $33.88 Median $38.90 Typical High $46.77 | Professional | 52 · Reduced service | $33.88 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.85 Typical High $18.62 | Professional | 53 · Discontinued | $13.49 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $58.88 Typical High $69.18 | Professional | 54 · Surgery only | $50.12 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $10.00 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.94 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.76 | $7.94 | $9.33 |
Where West Virginia sits
The same service costs 3.8 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· 34th of 51
$97.72
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.