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 $208.93 Median $245.47 Typical High $309.03 | Professional | None | $208.93 | $245.47 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $302.00 Typical High $446.68 | Facility | None | $34.67 | $302.00 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $741.31 | Professional | None | $234.42 | $407.38 | $741.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $1,548.82 | Facility | None | $151.36 | $436.52 | $1,548.82 |
United Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $512.86 | Professional | None | $165.96 | $275.42 | $512.86 |
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 $104.71 Median $123.03 Typical High $134.90 | Professional | 52 · Reduced service | $104.71 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $48.98 Typical High $53.70 | Professional | 53 · Discontinued | $41.69 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $158.49 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $24.55 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.89 | $24.55 | $26.92 |
Where West Virginia sits
The same service costs 3.5 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· 33rd of 51
$316
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.