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 $32.36 Median $75.86 Typical High $977.24 | Facility | None | $32.36 | $75.86 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $69.18 Typical High $83.18 | Professional | None | $29.51 | $69.18 | $83.18 |
CareSource Setting Professional Modifier None Typical Low $33.88 Median $67.61 Typical High $109.65 | Professional | None | $33.88 | $67.61 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $46.77 Typical High $151.36 | Facility | None | $34.67 | $46.77 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $112.20 Typical High $512.86 | Professional | None | $37.15 | $112.20 | $512.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $158.49 Median $707.95 Typical High $4,073.80 | Facility | None | $158.49 | $707.95 | $4,073.80 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $691.83 | Facility | None | $100.00 | $131.83 | $691.83 |
United Setting Professional Modifier None Typical Low $30.90 Median $75.86 Typical High $213.80 | Professional | None | $30.90 | $75.86 | $213.80 |
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 $14.79 Median $16.98 Typical High $37.15 | Professional | 52 · Reduced service | $14.79 | $16.98 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.76 Typical High $14.79 | Professional | 53 · Discontinued | $5.89 | $6.76 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $25.70 Typical High $54.95 | Professional | 54 · Surgery only | $21.88 | $25.70 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.13 Typical High $11.22 | Professional | 55 · Aftercare only | $4.47 | $5.13 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.39 Typical High $7.41 | Professional | 56 · Pre-op care only | $2.95 | $3.39 | $7.41 |
Where West Virginia sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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
$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.