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 $58.88 Median $81.28 Typical High $109.65 | Professional | None | $58.88 | $81.28 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $134.90 | Professional | None | $72.44 | $83.18 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $102.33 Typical High $186.21 | Facility | None | $34.67 | $102.33 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $229.09 | Professional | None | $77.62 | $128.82 | $229.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $223.87 Median $512.86 Typical High $1,202.26 | Facility | None | $223.87 | $512.86 | $1,202.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $144.54 | Professional | None | $97.72 | $134.90 | $144.54 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $776.25 | Facility | None | $100.00 | $131.83 | $776.25 |
United Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $144.54 | Professional | None | $47.86 | $77.62 | $144.54 |
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 $29.51 Median $35.48 Typical High $40.74 | Professional | 52 · Reduced service | $29.51 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $14.13 Typical High $16.22 | Professional | 53 · Discontinued | $11.75 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.72 Typical High $12.02 | Professional | 55 · Aftercare only | $8.91 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.08 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.89 | $7.08 | $8.13 |
Where West Virginia sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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
$93.33
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.