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 $1,621.81 | Facility | None | $1,412.54 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $776.25 | Professional | None | $562.34 | $660.69 | $776.25 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $933.25 Typical High $3,090.30 | Facility | None | $537.03 | $933.25 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,995.26 | Professional | None | $616.60 | $758.58 | $1,995.26 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $12,882.50 | Facility | None | $7,079.46 | $7,079.46 | $12,882.50 |
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 $537.03 Median $812.83 Typical High $1,659.59 | Professional | None | $537.03 | $812.83 | $1,659.59 |
7 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 $281.84 Median $309.03 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $112.20 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $489.78 |
Highmark BCBS Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 79 · Unrelated procedure after surgery | $1,047.13 | $1,047.13 | $1,047.13 |
Where West Virginia sits
The same service costs 4.2 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· 35th of 51
$759
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.