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 $29.51 Median $29.51 Typical High $33.11 | Professional | None | $29.51 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $2.95 |
CareSource Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
CareSource Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $64.57 | Professional | None | $38.02 | $38.02 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $75.86 | Facility | None | $35.48 | $35.48 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $263.03 | Professional | None | $25.70 | $25.70 | $263.03 |
Highmark BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $47.86 | Professional | None | $43.65 | $43.65 | $47.86 |
United Setting Professional Modifier None Typical Low $26.92 Median $34.67 Typical High $64.57 | Professional | None | $26.92 | $34.67 | $64.57 |
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 Facility Modifier KX · Policy requirements met Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | KX · Policy requirements met | $61.66 | $61.66 | $61.66 |
Where West Virginia sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 45th of 51
$29.51
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.