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 $19.50 Median $21.88 Typical High $31.62 | Professional | None | $19.50 | $21.88 | $31.62 |
CareSource Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | None | $20.89 | $20.89 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $34.67 | Facility | None | $32.36 | $32.36 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $141.25 | Professional | None | $23.99 | $33.11 | $141.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $309.03 Median $354.81 Typical High $363.08 | Facility | None | $309.03 | $354.81 | $363.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $25.12 Median $28.18 Typical High $51.29 | Professional | None | $25.12 | $28.18 | $51.29 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $457.09 | Facility | None | $100.00 | $131.83 | $457.09 |
United Setting Professional Modifier None Typical Low $19.95 Median $53.70 Typical High $112.20 | Professional | None | $19.95 | $53.70 | $112.20 |
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 $9.77 Median $10.96 Typical High $14.13 | Professional | 52 · Reduced service | $9.77 | $10.96 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $4.37 Typical High $5.62 | Professional | 53 · Discontinued | $3.89 | $4.37 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $16.60 Typical High $21.38 | Professional | 54 · Surgery only | $14.79 | $16.60 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.31 Typical High $4.27 | Professional | 55 · Aftercare only | $2.95 | $3.31 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.19 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.95 | $2.19 | $2.82 |
Where West Virginia sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 38th of 51
$33.11
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.