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 $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | None | $389.05 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $194.98 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $77.62 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $575.44 Typical High $741.31 | Facility | None | $389.05 | $575.44 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $1,659.59 | Professional | None | $389.05 | $389.05 | $1,659.59 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $575.44 | Professional | None | $295.12 | $389.05 | $575.44 |
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 JZ · No drug discarded Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | JZ · No drug discarded | $436.52 | $436.52 | $436.52 |
Where West Virginia sits
The same service costs 1.7 times more in Alaska than in Oklahoma. 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
$389
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.