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 $9.33 Median $11.48 Typical High $12.88 | Facility | None | $9.33 | $11.48 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $93.33 Typical High $125.89 | Professional | None | $9.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.68 Median $5.75 Typical High $45.71 | Professional | 52 · Reduced service | $4.68 | $5.75 | $45.71 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $165.96 | Professional | None | $102.33 | $114.82 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $263.03 | Professional | None | $87.10 | $109.65 | $263.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $165.96 | Professional | None | $74.13 | $97.72 | $165.96 |
2 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 55 · Aftercare only Typical Low $11.48 Median $14.45 Typical High $19.50 | Professional | 55 · Aftercare only | $11.48 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.55 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.59 | $9.55 | $12.88 |
Where West Virginia sits
The same service costs 2.5 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
$97.72
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.