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 $141.25 Median $162.18 Typical High $181.97 | Professional | None | $141.25 | $162.18 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $223.87 Typical High $245.47 | Facility | None | $34.67 | $223.87 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $1,071.52 | Professional | None | $154.88 | $275.42 | $1,071.52 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $2,570.40 | Facility | None | $151.36 | $436.52 | $2,570.40 |
United Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $446.68 | Professional | None | $123.03 | $190.55 | $446.68 |
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 $70.79 Median $81.28 Typical High $91.20 | Professional | 52 · Reduced service | $70.79 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $32.36 Typical High $36.31 | Professional | 53 · Discontinued | $28.84 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $107.15 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.99 Typical High $27.54 | Professional | 55 · Aftercare only | $21.38 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $18.20 |
Where West Virginia sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 33rd of 51
$219
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.