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 $52.48 Median $109.65 Typical High $5,623.41 | Facility | None | $52.48 | $109.65 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $83.18 Typical High $112.20 | Professional | None | $46.77 | $83.18 | $112.20 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $158.49 | Professional | None | $57.54 | $97.72 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $77.62 | Facility | None | $34.67 | $34.67 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $125.89 Typical High $512.86 | Professional | None | $61.66 | $125.89 | $512.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $5,370.32 | Facility | None | $169.82 | $302.00 | $5,370.32 |
Highmark BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
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 $44.67 Median $83.18 Typical High $186.21 | Professional | None | $44.67 | $83.18 | $186.21 |
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 $23.44 Median $30.20 Typical High $50.12 | Professional | 52 · Reduced service | $23.44 | $30.20 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.02 Typical High $19.95 | Professional | 53 · Discontinued | $9.33 | $12.02 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $45.71 Typical High $74.13 | Professional | 54 · Surgery only | $35.48 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.12 Typical High $14.79 | Professional | 55 · Aftercare only | $7.08 | $9.12 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.03 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.68 | $6.03 | $10.00 |
Where West Virginia sits
The same service costs 3.2 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· 25th of 51
$100
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.