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 $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $10,000.00 | Facility | None | $501.19 | $501.19 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $1,737.80 | Professional | None | $331.13 | $331.13 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $4,073.80 Typical High $20,417.38 | Facility | None | $1,905.46 | $4,073.80 | $20,417.38 |
United Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $1,000.00 | Professional | None | $281.84 | $426.58 | $1,000.00 |
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 $177.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
Where West Virginia sits
The same service costs 4.5 times more in Alaska than in New York. 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
$355
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.