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 $107.15 Median $144.54 Typical High $173.78 | Professional | None | $107.15 | $144.54 | $173.78 |
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 $181.97 Typical High $323.59 | Facility | None | $34.67 | $181.97 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $457.09 | Professional | None | $154.88 | $269.15 | $457.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $1,348.96 | Facility | None | $549.54 | $549.54 | $1,348.96 |
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 $95.50 Median $158.49 Typical High $309.03 | Professional | None | $95.50 | $158.49 | $309.03 |
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 $53.70 Median $67.61 Typical High $79.43 | Professional | 52 · Reduced service | $53.70 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.92 Typical High $31.62 | Professional | 53 · Discontinued | $21.88 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $102.33 Typical High $120.23 | Professional | 54 · Surgery only | $81.28 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $16.22 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.72 | $13.49 | $15.85 |
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· 34th of 51
$182
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.