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 $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 52 · Reduced service | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | 53 · Discontinued | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | 55 · Aftercare only | $1.15 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $0.78 |
CareSource Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $6.61 Median $12.30 Typical High $134.90 | Professional | None | $6.61 | $12.30 | $134.90 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None Typical Low $6.46 Median $10.47 Typical High $22.91 | Professional | None | $6.46 | $10.47 | $22.91 |
1 more rate 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 54 · Surgery only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 54 · Surgery only | $5.75 | $5.75 | $5.75 |
Where West Virginia sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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
$9.77
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.