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 $47.86 Median $70.79 Typical High $95.50 | Professional | None | $47.86 | $70.79 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $83.18 Typical High $186.21 | Facility | None | $34.67 | $83.18 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $144.54 Typical High $724.44 | Professional | None | $66.07 | $144.54 | $724.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $331.13 Median $870.96 Typical High $2,238.72 | Facility | None | $331.13 | $870.96 | $2,238.72 |
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 $50.12 Median $104.71 Typical High $269.15 | Professional | None | $50.12 | $104.71 | $269.15 |
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 $23.99 Median $29.51 Typical High $47.86 | Professional | 52 · Reduced service | $23.99 | $29.51 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.75 Typical High $19.05 | Professional | 53 · Discontinued | $9.55 | $11.75 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $43.65 Typical High $70.79 | Professional | 54 · Surgery only | $36.31 | $43.65 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.91 Typical High $14.13 | Professional | 55 · Aftercare only | $7.24 | $8.91 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.89 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.79 | $5.89 | $9.55 |
Where West Virginia sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 31st of 51
$107
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.