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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $251.19 | Professional | None | $154.88 | $218.78 | $251.19 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $446.68 Typical High $1,318.26 | Facility | None | $251.19 | $446.68 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $660.69 | Professional | None | $169.82 | $245.47 | $660.69 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,137.96 | Facility | None | $1,949.84 | $1,949.84 | $2,137.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | None | $346.74 | $346.74 | $363.08 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $1,995.26 | Facility | None | $151.36 | $436.52 | $1,995.26 |
United Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $537.03 | Professional | None | $141.25 | $229.09 | $537.03 |
6 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 $77.62 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $77.62 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $45.71 | Professional | 53 · Discontinued | $31.62 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $173.78 | Professional | 54 · Surgery only | $117.49 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.70 Typical High $34.67 | Professional | 55 · Aftercare only | $23.44 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.49 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $120.23 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $109.65 | $120.23 | $162.18 |
Where West Virginia sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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· 42nd of 51
$229
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.