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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | None | $100.00 | $100.00 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $147.91 | Facility | None | $34.67 | $34.67 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $309.03 | Professional | None | $97.72 | $144.54 | $309.03 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $1,230.27 | Facility | None | $100.00 | $131.83 | $1,230.27 |
United Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $199.53 | Professional | None | $83.18 | $114.82 | $199.53 |
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 $48.98 Median $48.98 Typical High $53.70 | Professional | 52 · Reduced service | $48.98 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | 53 · Discontinued | $19.95 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | 54 · Surgery only | $74.13 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.85 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.72 |
Where West Virginia sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 31st of 51
$123
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.