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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $162.18 | Professional | None | $69.18 | $70.79 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $162.18 Typical High $426.58 | Professional | None | $58.88 | $162.18 | $426.58 |
United Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
United Setting Professional Modifier None Typical Low $61.66 Median $147.91 Typical High $338.84 | Professional | None | $61.66 | $147.91 | $338.84 |
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 $33.88 Median $34.67 Typical High $79.43 | Professional | 52 · Reduced service | $33.88 | $34.67 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.80 Typical High $31.62 | Professional | 53 · Discontinued | $13.49 | $13.80 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $51.29 Typical High $117.49 | Professional | 54 · Surgery only | $50.12 | $51.29 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $23.99 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.92 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.76 | $6.92 | $15.85 |
Where West Virginia sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 32nd of 51
$148
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.