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 $67.61 Median $67.61 Typical High $95.50 | Facility | None | $67.61 | $67.61 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $134.90 | Professional | None | $64.57 | $87.10 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $37.15 Typical High $47.86 | Professional | 52 · Reduced service | $33.11 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.13 Typical High $19.05 | Professional | 53 · Discontinued | $13.49 | $14.13 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $100.00 Typical High $144.54 | Facility | None | $58.88 | $100.00 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $128.82 | Professional | None | $60.26 | $85.11 | $128.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $575.44 | Professional | None | $69.18 | $107.15 | $575.44 |
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 $54.95 Median $77.62 Typical High $123.03 | Professional | None | $54.95 | $77.62 | $123.03 |
2 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 55 · Aftercare only Typical Low $10.00 Median $11.22 Typical High $14.13 | Professional | 55 · Aftercare only | $10.00 | $11.22 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $9.55 |
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
$83.18
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.