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 $575.44 Median $707.95 Typical High $707.95 | Facility | None | $575.44 | $707.95 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $707.95 | Professional | None | $524.81 | $602.56 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $3,090.30 | Facility | None | $602.56 | $870.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,819.70 | Professional | None | $562.34 | $691.83 | $1,819.70 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $5,754.40 | Facility | None | $426.58 | $660.69 | $5,754.40 |
United Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,513.56 | Professional | None | $489.78 | $724.44 | $1,513.56 |
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 $263.03 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $263.03 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $446.68 |
Where West Virginia sits
The same service costs 4.3 times more in Alaska than in Texas. 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· 36th of 51
$692
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.