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 Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | None | $91.20 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $45.71 Typical High $46.77 | Professional | 52 · Reduced service | $45.71 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.62 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.33 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $144.54 | Professional | None | $89.13 | $97.72 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $467.74 | Professional | None | $83.18 | $83.18 | $467.74 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $134.90 | Professional | None | $64.57 | $85.11 | $134.90 |
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 93 · Audio-only telehealth + FQ · Audio-only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 93 · Audio-only telehealth + FQ · Audio-only | $77.62 | $85.11 | $85.11 |
Where West Virginia sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 34th of 51
$91.20
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.