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 $67.61 Median $70.79 Typical High $70.79 | Professional | None | $67.61 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.08 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $186.21 | Professional | None | $107.15 | $107.15 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $213.80 | Facility | None | $87.10 | $87.10 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $758.58 | Professional | None | $63.10 | $63.10 | $758.58 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $154.88 | Facility | None | $91.20 | $120.23 | $154.88 |
United Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $151.36 | Professional | None | $63.10 | $77.62 | $151.36 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | KX · Policy requirements met | $95.50 | $95.50 | $95.50 |
Where West Virginia sits
The same service costs 5.0 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
$70.79
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.