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 $67.61 Median $81.28 Typical High $147.91 | Professional | None | $67.61 | $81.28 | $147.91 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $316.23 Typical High $1,318.26 | Facility | None | $114.82 | $316.23 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $218.78 Typical High $812.83 | Professional | None | $91.20 | $218.78 | $812.83 |
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 $63.10 Median $123.03 Typical High $288.40 | Professional | None | $63.10 | $123.03 | $288.40 |
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 $33.88 Median $40.74 Typical High $74.13 | Professional | 52 · Reduced service | $33.88 | $40.74 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.22 Typical High $29.51 | Professional | 53 · Discontinued | $13.49 | $16.22 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $61.66 Typical High $112.20 | Professional | 54 · Surgery only | $51.29 | $61.66 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.30 Typical High $22.39 | Professional | 55 · Aftercare only | $10.23 | $12.30 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.76 | $8.13 | $14.79 |
Where West Virginia sits
The same service costs 3.6 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· 44th of 51
$132
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.