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 $69.18 Median $194.98 Typical High $489.78 | Professional | None | $69.18 | $194.98 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
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 $100.00 Median $363.08 Typical High $933.25 | Professional | None | $100.00 | $363.08 | $933.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $10,000.00 | Facility | None | $2,884.03 | $2,884.03 | $10,000.00 |
United Setting Professional Modifier None Typical Low $74.13 Median $257.04 Typical High $851.14 | Professional | None | $74.13 | $257.04 | $851.14 |
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 $34.67 Median $38.02 Typical High $199.53 | Professional | 52 · Reduced service | $34.67 | $38.02 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.49 Typical High $81.28 | Professional | 53 · Discontinued | $13.80 | $15.49 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $53.70 Typical High $302.00 | Professional | 54 · Surgery only | $51.29 | $53.70 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.48 Typical High $60.26 | Professional | 55 · Aftercare only | $10.23 | $11.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.59 Typical High $40.74 | Professional | 56 · Pre-op care only | $6.92 | $7.59 | $40.74 |
Where West Virginia sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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
$275
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.