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 $263.03 Median $389.05 Typical High $426.58 | Facility | None | $263.03 | $389.05 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $426.58 | Professional | None | $239.88 | $331.13 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $457.09 | Professional | None | $288.40 | $380.19 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $602.56 Typical High $1,862.09 | Facility | None | $380.19 | $602.56 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $588.84 Typical High $1,122.02 | Professional | None | $263.03 | $588.84 | $1,122.02 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $16,982.44 | Facility | None | $2,238.72 | $2,238.72 | $16,982.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | None | $524.81 | $575.44 | $575.44 |
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 $251.19 Median $407.38 Typical High $933.25 | Professional | None | $251.19 | $407.38 | $933.25 |
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 $120.23 Median $128.82 Typical High $194.98 | Professional | 52 · Reduced service | $120.23 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $181.97 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $36.31 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $181.97 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $169.82 | $181.97 | $275.42 |
Where West Virginia sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 40th of 51
$389
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.