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 $33.11 Median $38.90 Typical High $50.12 | Facility | None | $33.11 | $38.90 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $45.71 | Professional | None | $30.20 | $37.15 | $45.71 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $81.28 | Professional | None | $51.29 | $56.23 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $134.90 Typical High $181.97 | Facility | None | $50.12 | $134.90 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $89.13 | Professional | None | $33.11 | $47.86 | $89.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $30.20 Median $169.82 Typical High $223.87 | Facility | None | $30.20 | $169.82 | $223.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $36.31 Median $63.10 Typical High $100.00 | Professional | None | $36.31 | $63.10 | $100.00 |
United Setting Professional Modifier None Typical Low $18.20 Median $31.62 Typical High $57.54 | Professional | None | $18.20 | $31.62 | $57.54 |
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 $15.14 Median $16.60 Typical High $22.91 | Professional | 52 · Reduced service | $15.14 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.01 Typical High $6.76 | Professional | 55 · Aftercare only | $4.57 | $5.01 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.39 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.02 | $3.39 | $4.57 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $35.48 Median $61.66 Typical High $63.10 | Professional | 25 · Same-day visit | $35.48 | $61.66 | $63.10 |
Where West Virginia sits
The same service costs 2.4 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· 49th of 51
$35.48
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.