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 $288.40 Median $389.05 Typical High $389.05 | Facility | None | $288.40 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $389.05 | Professional | None | $257.04 | $316.23 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,659.59 Typical High $6,165.95 | Facility | None | $426.58 | $1,659.59 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $2,398.83 | Professional | None | $316.23 | $467.74 | $2,398.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $14,125.38 | Facility | None | $151.36 | $436.52 | $14,125.38 |
United Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $1,000.00 | Professional | None | $239.88 | $407.38 | $1,000.00 |
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 $128.82 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $128.82 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $63.10 Typical High $70.79 | Professional | 53 · Discontinued | $52.48 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $31.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.70 | $31.62 | $35.48 |
Where West Virginia sits
The same service costs 3.9 times more in Alaska than in New York. 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
$389
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.