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 $2.45 Median $2.75 Typical High $2.75 | Professional | None | $2.45 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | 52 · Reduced service | $1.38 | $1.38 | $1.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 53 · Discontinued | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | 55 · Aftercare only | $0.41 | $0.41 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
CareSource Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $3.24 | Facility | None | $2.88 | $2.88 | $3.24 |
CareSource Setting Professional Modifier None Typical Low $3.47 Median $5.01 Typical High $8.32 | Professional | None | $3.47 | $5.01 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $6.92 | Facility | None | $3.02 | $3.02 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $24.55 | Professional | None | $2.57 | $2.57 | $24.55 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.02 Typical High $5.62 | Professional | None | $2.40 | $3.02 | $5.62 |
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 $3.47 Median $3.47 Typical High $3.47 | Professional | KX · Policy requirements met | $3.47 | $3.47 | $3.47 |
Where West Virginia sits
The same service costs 2.3 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· 39th of 51
$2.75
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.