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 $288.40 Median $316.23 Typical High $380.19 | Professional | None | $288.40 | $316.23 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $398.11 Typical High $1,318.26 | Facility | None | $371.54 | $398.11 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $851.14 | Professional | None | $323.59 | $489.78 | $851.14 |
Highmark BCBS Setting Facility Modifier None Typical Low $457.09 Median $831.76 Typical High $891.25 | Facility | None | $457.09 | $831.76 | $891.25 |
Highmark BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $213.80 Median $323.59 Typical High $616.60 | Professional | None | $213.80 | $323.59 | $616.60 |
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 $144.54 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $57.54 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $204.17 | $218.78 | $218.78 |
Where West Virginia sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 31st of 51
$372
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.