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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $38.02 Typical High $39.81 | Professional | None | $22.39 | $38.02 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $109.65 | Professional | None | $46.77 | $66.07 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $104.71 | Facility | None | $45.71 | $45.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $380.19 | Professional | None | $33.11 | $33.11 | $380.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $281.84 | Facility | None | $93.33 | $93.33 | $281.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | None | $56.23 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $75.86 | Facility | None | $43.65 | $52.48 | $75.86 |
United Setting Professional Modifier None Typical Low $34.67 Median $41.69 Typical High $83.18 | Professional | None | $34.67 | $41.69 | $83.18 |
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 $18.20 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $18.20 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.41 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.50 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.63 | $3.80 | $3.80 |
Where West Virginia sits
The same service costs 3.8 times more in Hawaii than in Florida. 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
$38.02
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.