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 $43.65 Median $45.71 Typical High $70.79 | Professional | None | $43.65 | $45.71 | $70.79 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $75.86 | Facility | None | $34.67 | $34.67 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $79.43 Typical High $181.97 | Professional | None | $47.86 | $79.43 | $181.97 |
Highmark BCBS Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $562.34 | Facility | None | $100.00 | $131.83 | $562.34 |
United Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $154.88 | Professional | None | $42.66 | $70.79 | $154.88 |
4 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 $21.88 Median $22.91 Typical High $35.48 | Professional | 52 · Reduced service | $21.88 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $14.13 | Professional | 53 · Discontinued | $8.71 | $9.12 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.76 Typical High $10.47 | Professional | 55 · Aftercare only | $6.61 | $6.76 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.37 | $4.57 | $7.08 |
Where West Virginia sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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
$72.44
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.