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 $57.54 Median $58.88 Typical High $58.88 | Professional | None | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $28.84 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $5.89 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $141.25 | Professional | None | $81.28 | $81.28 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $162.18 | Facility | None | $70.79 | $70.79 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $562.34 | Professional | None | $51.29 | $51.29 | $562.34 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $120.23 | Facility | None | $57.54 | $63.10 | $120.23 |
United Setting Professional Modifier None Typical Low $56.23 Median $70.79 Typical High $131.83 | Professional | None | $56.23 | $70.79 | $131.83 |
1 more rate 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 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.75 | $11.75 | $11.75 |
Where West Virginia sits
The same service costs 2.4 times more in Montana than in Delaware. 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· 42nd of 51
$58.88
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.