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 $40.74 Median $58.88 Typical High $66.07 | Facility | None | $40.74 | $58.88 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $74.13 | Professional | None | $40.74 | $58.88 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $104.71 | Professional | None | $64.57 | $72.44 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $134.90 Typical High $181.97 | Facility | None | $85.11 | $134.90 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $154.88 | Professional | None | $47.86 | $69.18 | $154.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $154.88 Median $190.55 Typical High $208.93 | Facility | None | $154.88 | $190.55 | $208.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $125.89 | Professional | None | $48.98 | $79.43 | $125.89 |
United Setting Professional Modifier None Typical Low $34.67 Median $56.23 Typical High $89.13 | Professional | None | $34.67 | $56.23 | $89.13 |
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 $20.42 Median $26.92 Typical High $29.51 | Professional | 52 · Reduced service | $20.42 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $8.13 Typical High $8.91 | Professional | 55 · Aftercare only | $6.17 | $8.13 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.37 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.07 | $5.37 | $5.89 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $69.18 Median $79.43 Typical High $83.18 | Professional | 25 · Same-day visit | $69.18 | $79.43 | $83.18 |
Where West Virginia sits
The same service costs 2.2 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· 41st of 51
$58.88
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.