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 $2.51 Median $2.63 Typical High $2.63 | Professional | None | $2.51 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.26 |
CareSource Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $3.63 | Facility | None | $2.88 | $2.88 | $3.63 |
CareSource Setting Professional Modifier None Typical Low $3.09 Median $4.47 Typical High $7.24 | Professional | None | $3.09 | $4.47 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $6.31 | Facility | None | $2.95 | $2.95 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $22.91 | Professional | None | $2.45 | $2.45 | $22.91 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.75 Typical High $5.25 | Professional | None | $2.19 | $2.75 | $5.25 |
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 $3.31 Median $3.31 Typical High $3.31 | Professional | KX · Policy requirements met | $3.31 | $3.31 | $3.31 |
Where West Virginia sits
The same service costs 5.5 times more in Kansas than in Delaware. 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· 39th of 51
$2.63
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.