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 $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $125.89 | Professional | None | $93.33 | $102.33 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $151.36 | Facility | None | $34.67 | $34.67 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $302.00 | Professional | None | $107.15 | $169.82 | $302.00 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $1,258.93 | Facility | None | $100.00 | $131.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $239.88 | Professional | None | $79.43 | $112.20 | $239.88 |
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 $50.12 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $50.12 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $19.95 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $81.28 Typical High $95.50 | Professional | 54 · Surgery only | $75.86 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $15.14 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.00 | $10.96 | $12.59 |
Where West Virginia sits
The same service costs 4.5 times more in Alaska than in Florida. 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
$129
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.