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 $91.20 Median $102.33 Typical High $177.83 | Facility | None | $91.20 | $102.33 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $154.88 | Professional | None | $91.20 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $46.77 Typical High $50.12 | Professional | 52 · Reduced service | $45.71 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $15.14 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $10.23 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $181.97 | Professional | None | $109.65 | $123.03 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $1,862.09 Typical High $2,398.83 | Facility | None | $141.25 | $1,862.09 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $346.74 | Professional | None | $102.33 | $120.23 | $346.74 |
Highmark BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $173.78 | Professional | None | $79.43 | $107.15 | $173.78 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier 25 · Same-day visit Typical Low $36.31 Median $467.74 Typical High $776.25 | Facility | 25 · Same-day visit | $36.31 | $467.74 | $776.25 |
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· 44th of 51
$107
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.