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 $109.65 Median $114.82 Typical High $234.42 | Professional | None | $109.65 | $114.82 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $181.97 | Facility | None | $34.67 | $34.67 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $363.08 Typical High $676.08 | Professional | None | $165.96 | $363.08 | $676.08 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $2,187.76 | Facility | None | $691.83 | $691.83 | $2,187.76 |
United Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $575.44 | Professional | None | $123.03 | $257.04 | $575.44 |
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 $54.95 Median $57.54 Typical High $117.49 | Professional | 52 · Reduced service | $54.95 | $57.54 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $46.77 | Professional | 53 · Discontinued | $21.88 | $22.91 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $87.10 Typical High $173.78 | Professional | 54 · Surgery only | $81.28 | $87.10 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $34.67 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $23.44 |
Where West Virginia sits
The same service costs 3.4 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· 22nd of 51
$269
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.