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 $107.15 Median $107.15 Typical High $114.82 | Professional | None | $107.15 | $107.15 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $158.49 Typical High $660.69 | Facility | None | $34.67 | $158.49 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $588.84 | Professional | None | $104.71 | $158.49 | $588.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
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 $77.62 Median $104.71 Typical High $173.78 | Professional | None | $77.62 | $104.71 | $173.78 |
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 $53.70 Median $53.70 Typical High $57.54 | Professional | 52 · Reduced service | $53.70 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $22.91 | Professional | 53 · Discontinued | $21.38 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 54 · Surgery only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $17.38 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $11.48 |
Where West Virginia sits
The same service costs 4.8 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· 36th of 51
$117
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.