How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $43.65 Median $102.33 Typical High $125.89 | Facility | None | $43.65 | $102.33 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $75.86 Typical High $125.89 | Professional | None | $39.81 | $75.86 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $162.18 | Professional | None | $100.00 | $109.65 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $69.18 | Facility | None | $34.67 | $34.67 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $114.82 Typical High $229.09 | Professional | None | $50.12 | $114.82 | $229.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $104.71 Median $323.59 Typical High $346.74 | Facility | None | $104.71 | $323.59 | $346.74 |
Highmark BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $457.09 | Facility | None | $100.00 | $131.83 | $457.09 |
United Setting Professional Modifier None Typical Low $30.90 Median $63.10 Typical High $125.89 | Professional | None | $30.90 | $63.10 | $125.89 |
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 $19.95 Median $30.20 Typical High $56.23 | Professional | 52 · Reduced service | $19.95 | $30.20 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $12.30 Typical High $22.91 | Professional | 53 · Discontinued | $7.94 | $12.30 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $45.71 Typical High $85.11 | Professional | 54 · Surgery only | $29.51 | $45.71 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.12 Typical High $16.98 | Professional | 55 · Aftercare only | $6.03 | $9.12 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.03 Typical High $11.48 | Professional | 56 · Pre-op care only | $3.98 | $6.03 | $11.48 |
Where West Virginia sits
The same service costs 3.4 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· 43rd of 51
$75.86
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.