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 $50.12 Median $70.79 Typical High $85.11 | Professional | None | $50.12 | $70.79 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $77.62 | Facility | None | $34.67 | $34.67 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $549.54 | Professional | None | $61.66 | $114.82 | $549.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $239.88 Median $489.78 Typical High $1,023.29 | Facility | None | $239.88 | $489.78 | $1,023.29 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $562.34 | Facility | None | $100.00 | $131.83 | $562.34 |
United Setting Professional Modifier None Typical Low $47.86 Median $100.00 Typical High $281.84 | Professional | None | $47.86 | $100.00 | $281.84 |
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 $24.55 Median $28.84 Typical High $36.31 | Professional | 52 · Reduced service | $24.55 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.48 Typical High $14.79 | Professional | 53 · Discontinued | $10.00 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $43.65 Typical High $54.95 | Professional | 54 · Surgery only | $37.15 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.71 Typical High $10.96 | Professional | 55 · Aftercare only | $7.41 | $8.71 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.75 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.01 | $5.75 | $7.41 |
Where West Virginia sits
The same service costs 3.2 times more in Wisconsin 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· 34th of 51
$91.20
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.