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 $60.26 Median $61.66 Typical High $100.00 | Facility | None | $60.26 | $61.66 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $134.90 | Professional | None | $60.26 | $79.43 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $93.33 Typical High $134.90 | Facility | None | $58.88 | $93.33 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $125.89 | Professional | None | $57.54 | $81.28 | $125.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,174.90 Typical High $2,570.40 | Facility | None | $389.05 | $1,174.90 | $2,570.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $524.81 | Professional | None | $97.72 | $112.20 | $524.81 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $114.82 | Professional | None | $51.29 | $70.79 | $114.82 |
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 $30.90 Median $33.11 Typical High $42.66 | Professional | 52 · Reduced service | $30.90 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $17.38 | Professional | 53 · Discontinued | $12.30 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.00 Typical High $12.88 | Professional | 55 · Aftercare only | $9.12 | $10.00 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.17 | $6.61 | $8.71 |
Where Delaware sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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.
Delaware· 45th of 51
$79.43
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.