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 $275.42 Typical High $338.84 | Professional | None | $251.19 | $275.42 | $338.84 |
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 $467.74 | Facility | None | $34.67 | $371.54 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $741.31 | Professional | None | $288.40 | $436.52 | $741.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $741.31 | Facility | None | $323.59 | $323.59 | $741.31 |
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 $257.04 Typical High $501.19 | Professional | None | $186.21 | $257.04 | $501.19 |
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 $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $50.12 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $194.98 |
Where West Virginia sits
The same service costs 5.4 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
$316
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.