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 $60.26 Median $60.26 Typical High $120.23 | Facility | None | $60.26 | $60.26 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | None | $58.88 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $29.51 Typical High $30.20 | Professional | 52 · Reduced service | $28.84 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $12.02 | Professional | 53 · Discontinued | $11.75 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.03 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $87.10 Typical High $109.65 | Facility | None | $58.88 | $87.10 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $89.13 | Professional | None | $60.26 | $66.07 | $89.13 |
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 $173.78 Median $173.78 Typical High $173.78 | Facility | JZ · No drug discarded | $173.78 | $173.78 | $173.78 |
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· 32nd of 51
$60.26
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.