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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $138.04 | Professional | None | $117.49 | $125.89 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $181.97 Typical High $208.93 | Facility | None | $34.67 | $181.97 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $954.99 | Professional | None | $144.54 | $186.21 | $954.99 |
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 $109.65 Median $177.83 Typical High $389.05 | Professional | None | $109.65 | $177.83 | $389.05 |
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 $58.88 Median $63.10 Typical High $69.18 | Professional | 52 · Reduced service | $58.88 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.12 Typical High $27.54 | Professional | 53 · Discontinued | $23.44 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $95.50 Typical High $104.71 | Professional | 54 · Surgery only | $89.13 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $20.89 | Professional | 55 · Aftercare only | $17.78 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.59 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.75 | $12.59 | $13.80 |
Where West Virginia sits
The same service costs 2.9 times more in Alaska 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· 34th of 51
$170
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.