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 $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $0.54 |
CareSource Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $6.31 | Facility | None | $4.57 | $4.57 | $6.31 |
CareSource Setting Professional Modifier None Typical Low $6.92 Median $9.77 Typical High $16.22 | Professional | None | $6.92 | $9.77 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $13.49 | Facility | None | $5.89 | $5.89 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $47.86 | Professional | None | $5.01 | $5.01 | $47.86 |
United Setting Professional Modifier None Typical Low $4.68 Median $5.89 Typical High $10.96 | Professional | None | $4.68 | $5.89 | $10.96 |
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 $6.92 Median $6.92 Typical High $6.92 | Professional | KX · Policy requirements met | $6.92 | $6.92 | $6.92 |
Where West Virginia sits
The same service costs 2.4 times more in Kansas than in Connecticut. 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· 37th of 51
$5.37
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.