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 $416.87 Median $1,412.54 Typical High $2,041.74 | Facility | None | $416.87 | $1,412.54 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,318.26 Typical High $3,235.94 | Professional | None | $371.54 | $1,318.26 | $3,235.94 |
CareSource Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,698.24 | $2,398.83 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $588.84 | Facility | None | $34.67 | $34.67 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $1,862.09 Typical High $4,677.35 | Professional | None | $501.19 | $1,862.09 | $4,677.35 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $6,918.31 Typical High $7,943.28 | Facility | None | $4,570.88 | $6,918.31 | $7,943.28 |
Highmark BCBS Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $891.25 | Professional | None | $575.44 | $630.96 | $891.25 |
United Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $15,488.17 | Facility | None | $4,466.84 | $4,466.84 | $15,488.17 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,071.52 Typical High $4,168.69 | Professional | None | $363.08 | $1,071.52 | $4,168.69 |
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 $186.21 Median $223.87 Typical High $933.25 | Professional | 52 · Reduced service | $186.21 | $223.87 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $91.20 Typical High $371.54 | Professional | 53 · Discontinued | $74.13 | $91.20 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $1,412.54 | Professional | 54 · Surgery only | $281.84 | $309.03 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $67.61 Typical High $281.84 | Professional | 55 · Aftercare only | $56.23 | $67.61 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $45.71 Typical High $186.21 | Professional | 56 · Pre-op care only | $37.15 | $45.71 | $186.21 |
Where West Virginia sits
The same service costs 6.2 times more in Washington 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· 42nd of 51
$1,445
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.