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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $72.44 | Professional | None | $38.02 | $45.71 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $1,318.26 | Facility | None | $64.57 | $64.57 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $109.65 Typical High $446.68 | Professional | None | $50.12 | $109.65 | $446.68 |
Highmark BCBS Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $501.19 | Facility | None | $489.78 | $489.78 | $501.19 |
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 $34.67 Median $69.18 Typical High $177.83 | Professional | None | $34.67 | $69.18 | $177.83 |
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 $19.05 Median $22.91 Typical High $36.31 | Professional | 52 · Reduced service | $19.05 | $22.91 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.12 Typical High $14.45 | Professional | 53 · Discontinued | $7.59 | $9.12 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $34.67 Typical High $54.95 | Professional | 54 · Surgery only | $28.18 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.92 Typical High $10.96 | Professional | 55 · Aftercare only | $5.62 | $6.92 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.57 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.80 | $4.57 | $7.24 |
Where West Virginia sits
The same service costs 3.4 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· 43rd of 51
$72.44
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.