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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
CareSource Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $5,888.44 | Professional | None | $3,388.44 | $3,388.44 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $6,760.83 | Facility | None | $2,884.03 | $2,884.03 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $23,442.29 | Professional | None | $2,089.30 | $2,089.30 | $23,442.29 |
United Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $5,248.07 | Professional | None | $2,290.87 | $3,019.95 | $5,248.07 |
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 $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | KX · Policy requirements met | $3,890.45 | $3,890.45 | $3,890.45 |
Where West Virginia sits
The same service costs 2.4 times more in Montana 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· 49th of 51
$2,344
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.