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 Professional Modifier None Typical Low $43.65 Median $107.15 Typical High $131.83 | Professional | None | $43.65 | $107.15 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $123.03 Typical High $239.88 | Professional | None | $44.67 | $123.03 | $239.88 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
United Setting Professional Modifier None Typical Low $36.31 Median $93.33 Typical High $204.17 | Professional | None | $36.31 | $93.33 | $204.17 |
4 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 $21.88 Median $39.81 Typical High $61.66 | Professional | 52 · Reduced service | $21.88 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $15.85 Typical High $24.55 | Professional | 53 · Discontinued | $8.71 | $15.85 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $11.75 Typical High $18.20 | Professional | 55 · Aftercare only | $6.61 | $11.75 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.94 Typical High $12.30 | Professional | 56 · Pre-op care only | $4.37 | $7.94 | $12.30 |
Where West Virginia sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 46th of 51
$93.33
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.