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 $323.59 Typical High $389.05 | Professional | None | $251.19 | $323.59 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $426.58 Typical High $758.58 | Facility | None | $34.67 | $426.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $912.01 | Professional | None | $309.03 | $537.03 | $912.01 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,884.03 | Facility | None | $2,754.23 | $2,754.23 | $2,884.03 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $4,570.88 | Facility | None | $151.36 | $436.52 | $4,570.88 |
United Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $588.84 | Professional | None | $199.53 | $316.23 | $588.84 |
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 $123.03 Median $147.91 Typical High $177.83 | Professional | 52 · Reduced service | $123.03 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $50.12 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $186.21 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $37.15 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.12 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $173.78 | $208.93 | $245.47 |
Where West Virginia sits
The same service costs 4.5 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· 29th 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.