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 Professional Modifier None Typical Low $25.12 Median $29.51 Typical High $53.70 | Professional | None | $25.12 | $29.51 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $39.81 | Facility | None | $34.67 | $34.67 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $67.61 Typical High $371.54 | Professional | None | $32.36 | $67.61 | $371.54 |
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 $23.99 Median $46.77 Typical High $117.49 | Professional | None | $23.99 | $46.77 | $117.49 |
4 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 $12.59 Median $14.79 Typical High $26.92 | Professional | 52 · Reduced service | $12.59 | $14.79 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.89 Typical High $10.72 | Professional | 53 · Discontinued | $5.01 | $5.89 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.37 Typical High $8.13 | Professional | 55 · Aftercare only | $3.80 | $4.37 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.95 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.51 | $2.95 | $5.37 |
Where West Virginia sits
The same service costs 3.5 times more in Wisconsin than in Utah. 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· 38th of 51
$53.70
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.