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 $295.12 Median $1,380.38 Typical High $1,380.38 | Facility | None | $295.12 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $758.58 Typical High $2,290.87 | Professional | None | $263.03 | $758.58 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $398.11 | Facility | None | $34.67 | $34.67 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $1,174.90 Typical High $3,630.78 | Professional | None | $363.08 | $1,174.90 | $3,630.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $8,912.51 | Facility | None | $2,884.03 | $2,884.03 | $8,912.51 |
United Setting Professional Modifier None Typical Low $269.15 Median $831.76 Typical High $3,311.31 | Professional | None | $269.15 | $831.76 | $3,311.31 |
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 $131.83 Median $154.88 Typical High $630.96 | Professional | 52 · Reduced service | $131.83 | $154.88 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $61.66 Typical High $251.19 | Professional | 53 · Discontinued | $52.48 | $61.66 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $213.80 Typical High $933.25 | Professional | 54 · Surgery only | $199.53 | $213.80 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $46.77 Typical High $190.55 | Professional | 55 · Aftercare only | $39.81 | $46.77 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.90 Typical High $125.89 | Professional | 56 · Pre-op care only | $26.30 | $30.90 | $125.89 |
Where West Virginia sits
The same service costs 4.7 times more in Wisconsin 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· 41st of 51
$1,023
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.