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 $64.57 Median $85.11 Typical High $102.33 | Professional | None | $64.57 | $85.11 | $102.33 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $109.65 Typical High $199.53 | Facility | None | $34.67 | $109.65 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $251.19 | Professional | None | $85.11 | $141.25 | $251.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $380.19 | Facility | None | $263.03 | $295.12 | $380.19 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $457.09 | Facility | None | $100.00 | $131.83 | $457.09 |
United Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $154.88 | Professional | None | $52.48 | $83.18 | $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 $32.36 Median $38.02 Typical High $44.67 | Professional | 52 · Reduced service | $32.36 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.14 Typical High $17.78 | Professional | 53 · Discontinued | $12.88 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $9.77 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.46 | $7.59 | $8.91 |
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· 33rd of 51
$97.72
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.