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 $295.12 Median $316.23 Typical High $354.81 | Professional | None | $295.12 | $316.23 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $331.13 Median $501.19 Typical High $891.25 | Professional | None | $331.13 | $501.19 | $891.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
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 $223.87 Median $338.84 Typical High $645.65 | Professional | None | $223.87 | $338.84 | $645.65 |
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 $147.91 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $147.91 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $223.87 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $208.93 | $223.87 | $223.87 |
Where West Virginia sits
The same service costs 5.9 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· 32nd of 51
$380
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.