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 $2,630.27 | Facility | None | $1,412.54 | $1,412.54 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $229.09 | Professional | None | $123.03 | $173.78 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $398.11 Typical High $2,290.87 | Facility | None | $190.55 | $398.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $331.13 Typical High $3,890.45 | Professional | None | $151.36 | $331.13 | $3,890.45 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,951.21 | Facility | None | $1,819.70 | $1,819.70 | $2,951.21 |
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 $104.71 Median $338.84 Typical High $1,659.59 | Professional | None | $104.71 | $338.84 | $1,659.59 |
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 $60.26 Median $70.79 Typical High $107.15 | Professional | 52 · Reduced service | $60.26 | $70.79 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.18 Typical High $43.65 | Professional | 53 · Discontinued | $24.55 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $104.71 Typical High $162.18 | Professional | 54 · Surgery only | $91.20 | $104.71 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $32.36 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.13 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.30 | $14.13 | $21.38 |
Where West Virginia sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 25th of 51
$282
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.