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 $1,412.54 Median $1,412.54 Typical High $3,630.78 | Facility | None | $1,412.54 | $1,412.54 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $2,344.23 | Professional | None | $162.18 | $186.21 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $257.04 Typical High $11,481.54 | Facility | None | $34.67 | $257.04 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $1,778.28 Typical High $7,244.36 | Professional | None | $204.17 | $1,778.28 | $7,244.36 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $16,595.87 | Facility | None | $1,698.24 | $3,162.28 | $16,595.87 |
United Setting Professional Modifier None Typical Low $147.91 Median $1,698.24 Typical High $7,079.46 | Professional | None | $147.91 | $1,698.24 | $7,079.46 |
5 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 $81.28 Median $93.33 Typical High $1,174.90 | Professional | 52 · Reduced service | $81.28 | $93.33 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $37.15 Typical High $467.74 | Professional | 53 · Discontinued | $32.36 | $37.15 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $138.04 Typical High $1,778.28 | Professional | 54 · Surgery only | $123.03 | $138.04 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $27.54 Typical High $354.81 | Professional | 55 · Aftercare only | $24.55 | $27.54 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.62 Typical High $234.42 | Professional | 56 · Pre-op care only | $16.22 | $18.62 | $234.42 |
Where West Virginia sits
The same service costs 33.1 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.
West Virginia· 39th of 51
$1,820
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.