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 $60.26 Median $125.89 Typical High $134.90 | Professional | None | $60.26 | $125.89 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $100.00 Typical High $309.03 | Facility | None | $34.67 | $100.00 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $691.83 | Professional | None | $77.62 | $177.83 | $691.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $4,365.16 | Facility | None | $426.58 | $660.69 | $4,365.16 |
United Setting Professional Modifier None Typical Low $51.29 Median $109.65 Typical High $288.40 | Professional | None | $51.29 | $109.65 | $288.40 |
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 $30.20 Median $34.67 Typical High $67.61 | Professional | 52 · Reduced service | $30.20 | $34.67 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.13 Typical High $26.92 | Professional | 53 · Discontinued | $12.02 | $14.13 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $52.48 Typical High $102.33 | Professional | 54 · Surgery only | $44.67 | $52.48 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.47 Typical High $20.42 | Professional | 55 · Aftercare only | $9.12 | $10.47 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.08 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.03 | $7.08 | $13.49 |
Where West Virginia sits
The same service costs 5.9 times more in Oklahoma than in Kentucky. 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· 37th of 51
$132
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.