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 $346.74 Median $354.81 Typical High $354.81 | Professional | None | $346.74 | $354.81 | $354.81 |
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 $537.03 Median $549.54 Typical High $2,454.71 | Facility | None | $537.03 | $549.54 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $2,398.83 | Professional | None | $363.08 | $537.03 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $5,370.32 | Facility | None | $1,202.26 | $1,479.11 | $5,370.32 |
United Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $676.08 | Professional | None | $288.40 | $398.11 | $676.08 |
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 $173.78 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $34.67 | $35.48 | $35.48 |
Where West Virginia sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 34th of 51
$437
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.