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 $123.03 Median $141.25 Typical High $186.21 | Facility | None | $123.03 | $141.25 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $169.82 | Professional | None | $112.20 | $138.04 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $245.47 | Professional | None | $154.88 | $169.82 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $190.55 | Facility | None | $134.90 | $181.97 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $354.81 | Professional | None | $128.82 | $162.18 | $354.81 |
Highmark BCBS Setting Facility Modifier None Typical Low $69.18 Median $75.86 Typical High $354.81 | Facility | None | $69.18 | $75.86 | $354.81 |
Highmark BCBS Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $245.47 | Professional | None | $141.25 | $186.21 | $245.47 |
United Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $194.98 | Professional | None | $91.20 | $125.89 | $194.98 |
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 $56.23 Median $64.57 Typical High $69.18 | Professional | 52 · Reduced service | $56.23 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.88 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.22 | $12.88 | $13.80 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $141.25 Median $177.83 Typical High $288.40 | Professional | 25 · Same-day visit | $141.25 | $177.83 | $288.40 |
Where West Virginia 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.
West Virginia· 40th of 51
$138
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.