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 $0.02 Median $0.02 Typical High $0.12 | Facility | None | $0.02 | $0.02 | $0.12 |
Aetna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.12 | Professional | None | $0.02 | $0.02 | $0.12 |
CareSource Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Cigna Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.04 | Facility | None | $0.02 | $0.03 | $0.04 |
Cigna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.19 Median $0.31 Typical High $1.35 | Facility | None | $0.19 | $0.31 | $1.35 |
Highmark BCBS Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | None | $0.02 | $0.02 | $0.03 |
United Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $4.37 | Professional | None | $0.02 | $0.02 | $4.37 |
3 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 $0.06 Median $0.06 Typical High $0.06 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where West Virginia sits
The same service costs 6.0 times more in Wyoming than in Massachusetts. 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· 10th of 51
$0.02
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.