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 $275.42 Median $295.12 Typical High $363.08 | Professional | None | $275.42 | $295.12 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $371.54 Typical High $501.19 | Facility | None | $34.67 | $371.54 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $812.83 | Professional | None | $302.00 | $457.09 | $812.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $467.74 | Facility | None | $457.09 | $457.09 | $467.74 |
Highmark BCBS Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $204.17 Median $295.12 Typical High $588.84 | Professional | None | $204.17 | $295.12 | $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 $138.04 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $41.69 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $194.98 | $204.17 | $204.17 |
Where West Virginia sits
The same service costs 5.8 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· 30th of 51
$363
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.