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 $1,412.54 Median $1,412.54 Typical High $1,737.80 | Facility | None | $1,412.54 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $912.01 | Professional | None | $707.95 | $812.83 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,148.15 Typical High $3,090.30 | Facility | None | $602.56 | $1,148.15 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $2,454.71 | Professional | None | $741.31 | $912.01 | $2,454.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $6,606.93 | Facility | None | $4,677.35 | $4,677.35 | $6,606.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $691.83 Median $1,023.29 Typical High $2,089.30 | Professional | None | $691.83 | $1,023.29 | $2,089.30 |
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 $354.81 Median $380.19 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $588.84 |
Where West Virginia sits
The same service costs 4.4 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· 38th of 51
$912
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.