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 $56.23 Median $72.44 Typical High $72.44 | Professional | None | $56.23 | $72.44 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $93.33 Typical High $131.83 | Facility | None | $34.67 | $93.33 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $223.87 | Professional | None | $61.66 | $107.15 | $223.87 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,548.13 | Facility | None | $3,235.94 | $3,235.94 | $3,548.13 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $4,365.16 | Facility | None | $426.58 | $660.69 | $4,365.16 |
United Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $125.89 | Professional | None | $45.71 | $69.18 | $125.89 |
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 $28.18 Median $34.67 Typical High $36.31 | Professional | 52 · Reduced service | $28.18 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.80 Typical High $14.45 | Professional | 53 · Discontinued | $11.22 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $52.48 Typical High $53.70 | Professional | 54 · Surgery only | $42.66 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.47 Typical High $10.72 | Professional | 55 · Aftercare only | $8.51 | $10.47 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.92 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.62 | $6.92 | $7.24 |
Where West Virginia sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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· 35th of 51
$77.62
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.