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 $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,348.96 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,951.21 | Facility | None | $1,230.27 | $1,230.27 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $10,715.19 | Professional | None | $891.25 | $891.25 | $10,715.19 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $2,238.72 | Facility | None | $1,071.52 | $1,202.26 | $2,238.72 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,137.96 | Professional | None | $954.99 | $1,230.27 | $2,137.96 |
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 K2 · Prosthesis level 2 Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | K2 · Prosthesis level 2 | $1,584.89 | $1,584.89 | $1,584.89 |
Where West Virginia sits
The same service costs 3.1 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· 50th of 51
$955
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.