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 $61.66 Median $67.61 Typical High $151.36 | Professional | None | $61.66 | $67.61 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $93.33 | Facility | None | $34.67 | $34.67 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $3,090.30 | Professional | None | $79.43 | $181.97 | $3,090.30 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $60.26 Median $144.54 Typical High $323.59 | Professional | None | $60.26 | $144.54 | $323.59 |
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 $30.90 Median $33.88 Typical High $75.86 | Professional | 52 · Reduced service | $30.90 | $33.88 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.49 Typical High $30.20 | Professional | 53 · Discontinued | $12.30 | $13.49 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $51.29 Typical High $112.20 | Professional | 54 · Surgery only | $45.71 | $51.29 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $22.39 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.76 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.17 | $6.76 | $15.14 |
Where West Virginia sits
The same service costs 3.7 times more in Wisconsin 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· 23rd of 51
$155
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.