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 $34.67 Median $43.65 Typical High $43.65 | Professional | None | $34.67 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.13 | $6.61 | $6.61 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $95.50 | Professional | None | $60.26 | $72.44 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $100.00 | Facility | None | $40.74 | $40.74 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $302.00 | Professional | None | $34.67 | $34.67 | $302.00 |
Cigna Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $18.20 Median $37.15 Typical High $77.62 | Professional | None | $18.20 | $37.15 | $77.62 |
2 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.31 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.16 | $3.31 | $4.27 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | KX · Policy requirements met | $52.48 | $52.48 | $52.48 |
Where West Virginia sits
The same service costs 6.6 times more in Hawaii than in Wyoming. 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
$37.15
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.