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 $75.86 Median $89.13 Typical High $102.33 | Professional | None | $75.86 | $89.13 | $102.33 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $120.23 Typical High $186.21 | Facility | None | $34.67 | $120.23 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $245.47 | Professional | None | $95.50 | $158.49 | $245.47 |
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 $64.57 Median $95.50 Typical High $190.55 | Professional | None | $64.57 | $95.50 | $190.55 |
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 $38.02 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $38.02 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $15.14 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $11.48 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.59 | $8.91 | $10.23 |
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· 29th of 51
$112
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.