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 $38.90 Median $60.26 Typical High $151.36 | Professional | None | $38.90 | $60.26 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $66.07 | Facility | None | $34.67 | $34.67 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $151.36 Typical High $389.05 | Professional | None | $50.12 | $151.36 | $389.05 |
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 $31.62 Median $83.18 Typical High $162.18 | Professional | None | $31.62 | $83.18 | $162.18 |
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 $19.50 Median $30.20 Typical High $75.86 | Professional | 52 · Reduced service | $19.50 | $30.20 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $12.02 Typical High $30.20 | Professional | 53 · Discontinued | $7.76 | $12.02 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $44.67 Typical High $112.20 | Professional | 54 · Surgery only | $29.51 | $44.67 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $9.12 Typical High $22.91 | Professional | 55 · Aftercare only | $5.89 | $9.12 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.03 Typical High $15.14 | Professional | 56 · Pre-op care only | $3.89 | $6.03 | $15.14 |
Where West Virginia sits
The same service costs 4.6 times more in Wisconsin 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· 41st of 51
$95.50
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.