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 Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $89.13 | Professional | None | $69.18 | $70.79 | $89.13 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $107.15 | Professional | None | $66.07 | $72.44 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $457.09 | Professional | None | $70.79 | $70.79 | $457.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $758.58 Median $933.25 Typical High $1,778.28 | Facility | None | $758.58 | $933.25 | $1,778.28 |
Highmark BCBS Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $141.25 | Professional | None | $83.18 | $91.20 | $141.25 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
United Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $114.82 | Professional | None | $51.29 | $69.18 | $114.82 |
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 $33.88 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $33.88 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $13.80 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.23 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $7.08 |
Where West Virginia sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 44th of 51
$70.79
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.