How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $104.71 Median $134.90 Typical High $346.74 | Facility | None | $104.71 | $134.90 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $177.83 | Professional | None | $104.71 | $131.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $190.55 | Facility | None | $102.33 | $125.89 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $204.17 | Professional | None | $123.03 | $169.82 | $204.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Highmark BCBS Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $331.13 | Professional | None | $162.18 | $251.19 | $331.13 |
United Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $177.83 | Professional | None | $100.00 | $134.90 | $177.83 |
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 $52.48 Median $64.57 Typical High $66.07 | Professional | 52 · Reduced service | $52.48 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $19.95 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $13.18 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $147.91 Median $213.80 Typical High $380.19 | Professional | 25 · Same-day visit | $147.91 | $213.80 | $380.19 |
Where Delaware sits
The same service costs 2.3 times more in Alaska than in Alabama. 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.
Delaware· 41st of 51
$135
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.