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 $1,621.81 | Facility | None | $1,412.54 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $1,584.89 | Professional | None | $354.81 | $426.58 | $1,584.89 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $616.60 Typical High $4,677.35 | Facility | None | $34.67 | $616.60 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,949.84 Typical High $4,786.30 | Professional | None | $489.78 | $1,949.84 | $4,786.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Facility | None | $12,302.69 | $12,302.69 | $12,302.69 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $9,772.37 | Facility | None | $1,202.26 | $1,479.11 | $9,772.37 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,047.13 Typical High $4,265.80 | Professional | None | $331.13 | $1,047.13 | $4,265.80 |
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 $177.83 Median $213.80 Typical High $794.33 | Professional | 52 · Reduced service | $177.83 | $213.80 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $85.11 Typical High $316.23 | Professional | 53 · Discontinued | $70.79 | $85.11 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $323.59 Typical High $1,174.90 | Professional | 54 · Surgery only | $263.03 | $323.59 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $234.42 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $158.49 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $158.49 |
Where West Virginia sits
The same service costs 3.6 times more in Iowa 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· 47th of 51
$1,288
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.