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 $251.19 Median $281.84 Typical High $316.23 | Professional | None | $251.19 | $281.84 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $416.87 Typical High $562.34 | Facility | None | $34.67 | $416.87 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $891.25 | Professional | None | $275.42 | $338.84 | $891.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Highmark BCBS Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $602.56 | Professional | None | $588.84 | $588.84 | $602.56 |
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 $389.05 Typical High $758.58 | Professional | None | $251.19 | $389.05 | $758.58 |
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 $125.89 Median $141.25 Typical High $154.88 | Professional | 52 · Reduced service | $125.89 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $50.12 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $234.42 | Professional | 54 · Surgery only | $190.55 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $25.12 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $218.78 |
Where West Virginia sits
The same service costs 4.7 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· 37th of 51
$339
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.