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 $186.21 Median $263.03 Typical High $331.13 | Professional | None | $186.21 | $263.03 | $331.13 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $338.84 | Professional | None | $223.87 | $281.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $302.00 Typical High $562.34 | Facility | None | $34.67 | $302.00 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $436.52 Typical High $776.25 | Professional | None | $208.93 | $436.52 | $776.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,290.87 | Facility | None | $1,047.13 | $1,380.38 | $2,290.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $478.63 | Professional | None | $380.19 | $389.05 | $478.63 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $1,148.15 | Facility | None | $100.00 | $131.83 | $1,148.15 |
United Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $645.65 | Professional | None | $169.82 | $275.42 | $645.65 |
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 $93.33 Median $100.00 Typical High $144.54 | Professional | 52 · Reduced service | $93.33 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $39.81 Typical High $57.54 | Professional | 53 · Discontinued | $37.15 | $39.81 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $151.36 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $43.65 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.95 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.62 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $141.25 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $128.82 | $141.25 | $204.17 |
Where West Virginia sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 29th of 51
$295
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.