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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $144.54 | Professional | None | $97.72 | $125.89 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $158.49 Typical High $257.04 | Facility | None | $34.67 | $158.49 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $363.08 | Professional | None | $120.23 | $199.53 | $363.08 |
Highmark BCBS Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $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 $79.43 Median $123.03 Typical High $239.88 | Professional | None | $79.43 | $123.03 | $239.88 |
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 $47.86 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $47.86 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.91 Typical High $25.70 | Professional | 53 · Discontinued | $19.50 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $19.05 | Professional | 55 · Aftercare only | $14.45 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.77 | $11.22 | $12.88 |
Where West Virginia sits
The same service costs 3.7 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· 30th of 51
$145
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.