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 $6.46 Median $6.46 Typical High $7.94 | Professional | None | $6.46 | $6.46 | $7.94 |
CareSource Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
CareSource Setting Professional Modifier None Typical Low $10.23 Median $10.47 Typical High $20.89 | Professional | None | $10.23 | $10.47 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $20.89 Typical High $22.39 | Facility | None | $16.60 | $20.89 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $60.26 | Professional | None | $15.49 | $15.49 | $60.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Professional Modifier None Typical Low $6.92 Median $11.75 Typical High $17.38 | Professional | None | $6.92 | $11.75 | $17.38 |
4 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 $3.24 Median $3.24 Typical High $3.24 | Professional | 52 · Reduced service | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 53 · Discontinued | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | 55 · Aftercare only | $0.98 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.65 | $0.65 | $0.65 |
Where West Virginia sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 34th of 51
$12.59
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.