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 Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $93.33 | Professional | None | $64.57 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $35.48 Typical High $45.71 | Professional | 52 · Reduced service | $33.11 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.72 Typical High $13.80 | Professional | 55 · Aftercare only | $9.77 | $10.72 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.24 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.61 | $7.24 | $9.12 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $141.25 | Professional | None | $89.13 | $97.72 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $208.93 | Professional | None | $64.57 | $95.50 | $208.93 |
Highmark BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $141.25 | Professional | None | $93.33 | $123.03 | $141.25 |
United Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $112.20 | Professional | None | $45.71 | $67.61 | $112.20 |
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 Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $123.03 Typical High $190.55 | Professional | 25 · Same-day visit | $93.33 | $123.03 | $190.55 |
Where West Virginia sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 41st of 51
$77.62
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.