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 $363.08 Median $426.58 Typical High $1,949.84 | Professional | None | $363.08 | $426.58 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $549.54 | Facility | None | $34.67 | $34.67 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,819.70 Typical High $5,754.40 | Professional | None | $489.78 | $1,819.70 | $5,754.40 |
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 $371.54 Median $1,202.26 Typical High $5,128.61 | Professional | None | $371.54 | $1,202.26 | $5,128.61 |
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 $181.97 Median $208.93 Typical High $977.24 | Professional | 52 · Reduced service | $181.97 | $208.93 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $85.11 Typical High $389.05 | Professional | 53 · Discontinued | $72.44 | $85.11 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $1,479.11 | Professional | 54 · Surgery only | $269.15 | $295.12 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $295.12 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $42.66 Typical High $194.98 | Professional | 56 · Pre-op care only | $36.31 | $42.66 | $194.98 |
Where West Virginia sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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
$1,585
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.