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 $169.82 Median $223.87 Typical High $354.81 | Professional | None | $169.82 | $223.87 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $1,513.56 | Professional | None | $288.40 | $288.40 | $1,513.56 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $1,258.93 | Facility | None | $100.00 | $131.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $169.82 Median $398.11 Typical High $1,071.52 | Professional | None | $169.82 | $398.11 | $1,071.52 |
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 $85.11 Median $112.20 Typical High $177.83 | Professional | 52 · Reduced service | $85.11 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $44.67 Typical High $70.79 | Professional | 53 · Discontinued | $34.67 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $269.15 | Professional | 54 · Surgery only | $128.82 | $165.96 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.11 Typical High $53.70 | Professional | 55 · Aftercare only | $25.70 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $22.39 Typical High $35.48 | Professional | 56 · Pre-op care only | $16.98 | $22.39 | $35.48 |
Where West Virginia sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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
$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.