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 $70.79 Median $100.00 Typical High $125.89 | Professional | None | $70.79 | $100.00 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $109.65 | Facility | None | $34.67 | $34.67 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $549.54 | Professional | None | $74.13 | $109.65 | $549.54 |
United Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
United Setting Professional Modifier None Typical Low $70.79 Median $138.04 Typical High $288.40 | Professional | None | $70.79 | $138.04 | $288.40 |
4 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 $35.48 Median $50.12 Typical High $63.10 | Professional | 52 · Reduced service | $35.48 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.95 Typical High $25.12 | Professional | 53 · Discontinued | $14.13 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.14 Typical High $19.05 | Professional | 55 · Aftercare only | $10.72 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.08 | $10.00 | $12.59 |
Where West Virginia sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 44th of 51
$115
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.