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 $81.28 Median $97.72 Typical High $112.20 | Professional | None | $81.28 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $40.74 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $12.02 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.71 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.13 | $8.71 | $10.72 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $165.96 | Professional | None | $104.71 | $114.82 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $245.47 | Professional | None | $81.28 | $109.65 | $245.47 |
Highmark BCBS Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Highmark BCBS Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $162.18 | Professional | None | $109.65 | $151.36 | $162.18 |
United Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $134.90 | Professional | None | $61.66 | $85.11 | $134.90 |
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 $128.82 Median $144.54 Typical High $223.87 | Professional | 25 · Same-day visit | $128.82 | $144.54 | $223.87 |
Where West Virginia sits
The same service costs 2.7 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· 43rd of 51
$93.33
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.