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 $2.57 Median $4.17 Typical High $4.17 | Professional | None | $2.57 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.63 Typical High $0.65 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.44 |
CareSource Setting Facility Modifier None Typical Low $0.66 Median $0.66 Typical High $4.90 | Facility | None | $0.66 | $0.66 | $4.90 |
CareSource Setting Professional Modifier None Typical Low $5.37 Median $7.59 Typical High $12.59 | Professional | None | $5.37 | $7.59 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $12.02 | Facility | None | $5.37 | $5.37 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $42.66 | Professional | None | $4.57 | $4.57 | $42.66 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $162.18 | Facility | None | $1.55 | $1.55 | $162.18 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.01 Typical High $8.51 | Professional | None | $3.80 | $5.01 | $8.51 |
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 KX · Policy requirements met Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | KX · Policy requirements met | $5.37 | $5.37 | $5.37 |
Where West Virginia sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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
$4.57
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.