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 $2,344.23 | Facility | None | $1,412.54 | $1,412.54 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $758.58 | Professional | None | $616.60 | $724.44 | $758.58 |
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 $741.31 Median $977.24 Typical High $8,128.31 | Facility | None | $741.31 | $977.24 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $2,041.74 | Professional | None | $645.65 | $1,096.48 | $2,041.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $16,595.87 | Facility | None | $1,698.24 | $3,162.28 | $16,595.87 |
United Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,348.96 | Professional | None | $478.63 | $691.83 | $1,348.96 |
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 $309.03 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $123.03 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $512.86 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $512.86 | $524.81 |
Where West Virginia sits
The same service costs 6.6 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· 33rd of 51
$832
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.