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 $123.03 Median $154.88 Typical High $154.88 | Professional | None | $123.03 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $61.66 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $24.55 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.30 | $15.49 | $15.49 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
United Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $112.20 | Professional | None | $79.43 | $87.10 | $112.20 |
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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where West Virginia sits
The same service costs 2.4 times more in Montana 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· 36th of 51
$87.10
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.