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 $1,621.81 | Facility | None | $1,412.54 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $28.84 Typical High $28.84 | Professional | None | $23.44 | $28.84 | $28.84 |
CareSource Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $38.02 Typical High $537.03 | Facility | None | $34.67 | $38.02 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $48.98 Typical High $112.20 | Professional | None | $26.92 | $48.98 | $112.20 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $851.14 | Facility | None | $100.00 | $131.83 | $851.14 |
United Setting Professional Modifier None Typical Low $19.95 Median $33.11 Typical High $64.57 | Professional | None | $19.95 | $33.11 | $64.57 |
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 $11.75 Median $14.13 Typical High $14.45 | Professional | 52 · Reduced service | $11.75 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $5.62 Typical High $5.75 | Professional | 53 · Discontinued | $4.68 | $5.62 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $21.38 Typical High $21.88 | Professional | 54 · Surgery only | $17.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.27 Typical High $4.37 | Professional | 55 · Aftercare only | $3.55 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.82 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.34 | $2.82 | $2.88 |
Where West Virginia sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 31st of 51
$38.02
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.