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 $66.07 Median $102.33 Typical High $102.33 | Facility | None | $66.07 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $131.83 | Professional | None | $60.26 | $93.33 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $151.36 | Professional | None | $74.13 | $93.33 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $97.72 Typical High $141.25 | Facility | None | $34.67 | $97.72 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $724.44 | Professional | None | $79.43 | $120.23 | $724.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $288.40 Median $363.08 Typical High $831.76 | Facility | None | $288.40 | $363.08 | $831.76 |
Highmark BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $562.34 | Facility | None | $100.00 | $131.83 | $562.34 |
United Setting Professional Modifier None Typical Low $61.66 Median $112.20 Typical High $263.03 | Professional | None | $61.66 | $112.20 | $263.03 |
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 $30.20 Median $39.81 Typical High $48.98 | Professional | 52 · Reduced service | $30.20 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.85 Typical High $19.50 | Professional | 53 · Discontinued | $12.02 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $58.88 Typical High $72.44 | Professional | 54 · Surgery only | $45.71 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.75 Typical High $14.45 | Professional | 55 · Aftercare only | $9.12 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.94 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.03 | $7.94 | $9.77 |
Where West Virginia sits
The same service costs 3.0 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
$102
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.