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 $52.48 Median $134.90 Typical High $134.90 | Facility | None | $52.48 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $104.71 Typical High $123.03 | Professional | None | $46.77 | $104.71 | $123.03 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $79.43 Typical High $323.59 | Facility | None | $34.67 | $79.43 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $151.36 Typical High $316.23 | Professional | None | $58.88 | $151.36 | $316.23 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $2,570.40 | Facility | None | $151.36 | $436.52 | $2,570.40 |
United Setting Professional Modifier None Typical Low $35.48 Median $81.28 Typical High $138.04 | Professional | None | $35.48 | $81.28 | $138.04 |
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 $23.44 Median $40.74 Typical High $61.66 | Professional | 52 · Reduced service | $23.44 | $40.74 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $16.22 Typical High $24.55 | Professional | 53 · Discontinued | $9.33 | $16.22 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $60.26 Typical High $91.20 | Professional | 54 · Surgery only | $35.48 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.02 Typical High $18.20 | Professional | 55 · Aftercare only | $7.08 | $12.02 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.13 Typical High $12.30 | Professional | 56 · Pre-op care only | $4.68 | $8.13 | $12.30 |
Where West Virginia sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 42nd of 51
$91.20
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.