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 $37.15 Median $37.15 Typical High $74.13 | Facility | None | $37.15 | $37.15 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $39.81 | Professional | None | $37.15 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $18.20 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.41 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.50 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.72 | $3.80 | $3.80 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $46.77 | Professional | None | $36.31 | $36.31 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $56.23 Typical High $70.79 | Facility | None | $38.02 | $56.23 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $43.65 | Professional | None | $37.15 | $40.74 | $43.65 |
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 $77.62 Median $77.62 Typical High $77.62 | Facility | JZ · No drug discarded | $77.62 | $77.62 | $77.62 |
Where West Virginia sits
Rates are fairly even across states for this service. 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· 21st of 51
$38.02
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.