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 $47.86 Median $53.70 Typical High $61.66 | Professional | None | $47.86 | $53.70 | $61.66 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $89.13 | Facility | None | $34.67 | $70.79 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $165.96 | Professional | None | $54.95 | $93.33 | $165.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $891.25 | Facility | None | $100.00 | $131.83 | $891.25 |
United Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $138.04 | Professional | None | $38.90 | $60.26 | $138.04 |
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 $23.99 Median $26.92 Typical High $30.90 | Professional | 52 · Reduced service | $23.99 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.72 Typical High $12.30 | Professional | 53 · Discontinued | $9.77 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $40.74 Typical High $46.77 | Professional | 54 · Surgery only | $36.31 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.13 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $8.13 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.37 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.79 | $5.37 | $6.17 |
Where West Virginia sits
The same service costs 3.7 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
$70.79
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.