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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $316.23 Typical High $676.08 | Professional | None | $144.54 | $316.23 | $676.08 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $251.19 | Facility | None | $34.67 | $34.67 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $501.19 Typical High $1,995.26 | Professional | None | $213.80 | $501.19 | $1,995.26 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $158.49 Median $323.59 Typical High $724.44 | Professional | None | $158.49 | $323.59 | $724.44 |
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 $72.44 Median $77.62 Typical High $158.49 | Professional | 52 · Reduced service | $72.44 | $77.62 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.90 Typical High $63.10 | Professional | 53 · Discontinued | $29.51 | $30.90 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $114.82 Typical High $234.42 | Professional | 54 · Surgery only | $109.65 | $114.82 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.91 Typical High $47.86 | Professional | 55 · Aftercare only | $21.88 | $22.91 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.49 Typical High $31.62 | Professional | 56 · Pre-op care only | $14.45 | $15.49 | $31.62 |
Where West Virginia sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 21st of 51
$363
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.