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 $2,630.27 | Facility | None | $1,412.54 | $1,412.54 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | None | $398.11 | $407.38 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $12,302.69 | Facility | None | $630.96 | $3,311.31 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $2,398.83 | Professional | None | $389.05 | $616.60 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $16,982.44 | Facility | None | $1,479.11 | $2,089.30 | $16,982.44 |
United Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $724.44 | Professional | None | $331.13 | $416.87 | $724.44 |
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 $199.53 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $40.74 |
Where West Virginia sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$479
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.