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 Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $691.83 | Professional | None | $426.58 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,000.00 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,995.26 | Facility | None | $831.76 | $831.76 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $6,918.31 | Professional | None | $616.60 | $616.60 | $6,918.31 |
United Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $1,445.44 | Facility | None | $630.96 | $794.33 | $1,445.44 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,513.56 | Professional | None | $575.44 | $741.31 | $1,513.56 |
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 KX · Policy requirements met Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | KX · Policy requirements met | $933.25 | $933.25 | $933.25 |
Where West Virginia sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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· 48th of 51
$692
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.