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 $1,621.81 | Facility | None | $1,412.54 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $794.33 Typical High $1,548.82 | Professional | None | $281.84 | $794.33 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $436.52 | Facility | None | $34.67 | $34.67 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $1,230.27 Typical High $5,248.07 | Professional | None | $380.19 | $1,230.27 | $5,248.07 |
Highmark BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $269.15 Median $707.95 Typical High $2,754.23 | Professional | None | $269.15 | $707.95 | $2,754.23 |
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 $141.25 Median $162.18 Typical High $524.81 | Professional | 52 · Reduced service | $141.25 | $162.18 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $66.07 Typical High $208.93 | Professional | 53 · Discontinued | $56.23 | $66.07 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $245.47 Typical High $776.25 | Professional | 54 · Surgery only | $208.93 | $245.47 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $48.98 Typical High $154.88 | Professional | 55 · Aftercare only | $41.69 | $48.98 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.11 Typical High $104.71 | Professional | 56 · Pre-op care only | $28.18 | $33.11 | $104.71 |
Where West Virginia sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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· 38th of 51
$832
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.