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 $5.89 Median $5.89 Typical High $16.98 | Facility | None | $5.89 | $5.89 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.37 Typical High $16.98 | Professional | None | $5.25 | $5.37 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $2.69 Typical High $8.51 | Professional | 52 · Reduced service | $2.63 | $2.69 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $3.39 | Professional | 53 · Discontinued | $1.07 | $1.07 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $2.51 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $1.70 |
CareSource Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $8.71 | Professional | None | $6.76 | $6.76 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $5.25 Median $7.94 Typical High $10.00 | Facility | None | $5.25 | $7.94 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $6.92 | Professional | None | $4.90 | $5.25 | $6.92 |
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 $12.02 Median $16.22 Typical High $19.95 | Facility | JZ · No drug discarded | $12.02 | $16.22 | $19.95 |
Where West Virginia sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 30th of 51
$5.25
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.