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 $52.48 Median $75.86 Typical High $87.10 | Professional | None | $52.48 | $75.86 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $87.10 Typical High $138.04 | Facility | None | $34.67 | $87.10 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $389.05 | Professional | None | $72.44 | $128.82 | $389.05 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,467.37 | Facility | None | $3,311.31 | $3,311.31 | $3,467.37 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $1,949.84 | Facility | None | $151.36 | $436.52 | $1,949.84 |
United Setting Professional Modifier None Typical Low $46.77 Median $95.50 Typical High $229.09 | Professional | None | $46.77 | $95.50 | $229.09 |
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 $25.70 Median $33.11 Typical High $38.90 | Professional | 52 · Reduced service | $25.70 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.18 Typical High $15.85 | Professional | 53 · Discontinued | $10.47 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $48.98 Typical High $58.88 | Professional | 54 · Surgery only | $38.90 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.00 Typical High $11.75 | Professional | 55 · Aftercare only | $7.76 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.61 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.25 | $6.61 | $7.94 |
Where West Virginia sits
The same service costs 3.2 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· 40th of 51
$87.10
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.