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 $85.11 Median $125.89 Typical High $199.53 | Professional | None | $85.11 | $125.89 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $398.11 Typical High $3,890.45 | Facility | None | $141.25 | $398.11 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $251.19 Typical High $562.34 | Professional | None | $104.71 | $251.19 | $562.34 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $7,762.47 | Facility | None | $426.58 | $660.69 | $7,762.47 |
United Setting Professional Modifier None Typical Low $61.66 Median $128.82 Typical High $218.78 | Professional | None | $61.66 | $128.82 | $218.78 |
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 $42.66 Median $63.10 Typical High $100.00 | Professional | 52 · Reduced service | $42.66 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $25.12 Typical High $39.81 | Professional | 53 · Discontinued | $16.98 | $25.12 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $95.50 Typical High $147.91 | Professional | 54 · Surgery only | $64.57 | $95.50 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $19.05 Typical High $29.51 | Professional | 55 · Aftercare only | $12.88 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.59 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.51 | $12.59 | $19.95 |
Where West Virginia sits
The same service costs 4.5 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· 45th of 51
$138
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.