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 Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $60.26 | Professional | None | $43.65 | $56.23 | $60.26 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $69.18 Typical High $104.71 | Facility | None | $34.67 | $69.18 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $95.50 Typical High $173.78 | Professional | None | $53.70 | $95.50 | $173.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $457.09 | Facility | None | $100.00 | $131.83 | $457.09 |
United Setting Professional Modifier None Typical Low $35.48 Median $57.54 Typical High $114.82 | Professional | None | $35.48 | $57.54 | $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 $21.88 Median $25.12 Typical High $30.20 | Professional | 52 · Reduced service | $21.88 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.23 Typical High $12.02 | Professional | 53 · Discontinued | $8.71 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.59 Typical High $9.12 | Professional | 55 · Aftercare only | $6.61 | $7.59 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.13 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.37 | $5.13 | $6.03 |
Where West Virginia sits
The same service costs 3.5 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· 31st of 51
$67.61
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.