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 $275.42 Median $288.40 Typical High $288.40 | Facility | None | $275.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $288.40 | Professional | None | $251.19 | $263.03 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $371.54 Typical High $457.09 | Facility | None | $34.67 | $371.54 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $724.44 | Professional | None | $281.84 | $407.38 | $724.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | None | $416.87 | $416.87 | $501.19 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $691.83 | Facility | None | $100.00 | $131.83 | $691.83 |
United Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $537.03 | Professional | None | $186.21 | $275.42 | $537.03 |
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 $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $50.12 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $190.55 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $177.83 | $181.97 | $181.97 |
Where West Virginia sits
The same service costs 5.9 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· 32nd of 51
$309
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.