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 $97.72 Median $97.72 Typical High $104.71 | Professional | None | $97.72 | $97.72 | $104.71 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $512.86 | Professional | None | $93.33 | $95.50 | $512.86 |
United Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
United Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $218.78 | Professional | None | $74.13 | $109.65 | $218.78 |
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 $47.86 Median $47.86 Typical High $52.48 | Professional | 52 · Reduced service | $47.86 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $20.89 | Professional | 53 · Discontinued | $19.50 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $15.85 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.47 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.47 |
Where West Virginia sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 48th of 51
$100
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.