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 $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $398.11 | Professional | None | $169.82 | $239.88 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $331.13 | Facility | None | $151.36 | $151.36 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $1,174.90 | Professional | None | $112.20 | $112.20 | $1,174.90 |
Highmark BCBS Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | None | $181.97 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $263.03 | Professional | None | $109.65 | $131.83 | $263.03 |
5 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $58.88 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $17.78 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Highmark BCBS Setting Facility Modifier GY · Excluded by law Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | GY · Excluded by law | $239.88 | $239.88 | $239.88 |
Where West Virginia sits
The same service costs 2.1 times more in Hawaii than in Utah. 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· 40th of 51
$120
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.