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 $53.70 Median $275.42 Typical High $275.42 | Facility | None | $53.70 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $141.25 Typical High $426.58 | Professional | None | $48.98 | $141.25 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $74.13 | Facility | None | $34.67 | $34.67 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $309.03 Typical High $1,862.09 | Professional | None | $66.07 | $309.03 | $1,862.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $47.86 Median $162.18 Typical High $660.69 | Professional | None | $47.86 | $162.18 | $660.69 |
6 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 $24.55 Median $29.51 Typical High $125.89 | Professional | 52 · Reduced service | $24.55 | $29.51 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $11.75 Typical High $50.12 | Professional | 53 · Discontinued | $9.77 | $11.75 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $39.81 Typical High $186.21 | Professional | 54 · Surgery only | $37.15 | $39.81 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.71 Typical High $37.15 | Professional | 55 · Aftercare only | $7.41 | $8.71 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $4.90 | $5.89 | $25.12 |
Highmark BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 50 · Both sides | $107.15 | $107.15 | $107.15 |
Where West Virginia sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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
$214
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.