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 $134.90 Median $144.54 Typical High $288.40 | Professional | None | $134.90 | $144.54 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $239.88 | Facility | None | $34.67 | $34.67 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $2,089.30 | Professional | None | $199.53 | $457.09 | $2,089.30 |
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 $151.36 Median $295.12 Typical High $676.08 | Professional | None | $151.36 | $295.12 | $676.08 |
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 $67.61 Median $70.79 Typical High $144.54 | Professional | 52 · Reduced service | $67.61 | $70.79 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.84 Typical High $57.54 | Professional | 53 · Discontinued | $26.92 | $28.84 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $107.15 Typical High $213.80 | Professional | 54 · Surgery only | $102.33 | $107.15 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.38 Typical High $42.66 | Professional | 55 · Aftercare only | $20.42 | $21.38 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.45 Typical High $28.84 | Professional | 56 · Pre-op care only | $13.49 | $14.45 | $28.84 |
Where West Virginia sits
The same service costs 3.5 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· 20th of 51
$347
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.