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 $32.36 Median $36.31 Typical High $87.10 | Facility | None | $32.36 | $36.31 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $66.07 Typical High $87.10 | Professional | None | $32.36 | $66.07 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $75.86 | Professional | None | $46.77 | $56.23 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $213.80 | Professional | None | $50.12 | $69.18 | $213.80 |
Highmark BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | None | $50.12 | $50.12 | $83.18 |
United Setting Professional Modifier None Typical Low $27.54 Median $38.90 Typical High $87.10 | Professional | None | $27.54 | $38.90 | $87.10 |
3 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 $16.22 Median $16.22 Typical High $18.62 | Professional | 52 · Reduced service | $16.22 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $5.62 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.72 |
Where West Virginia sits
The same service costs 2.7 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· 12th of 51
$66.07
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.