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 $1,412.54 Median $1,412.54 Typical High $1,737.80 | Facility | None | $1,412.54 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $316.23 | Professional | None | $269.15 | $302.00 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,862.09 Typical High $2,344.23 | Facility | None | $457.09 | $1,862.09 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $870.96 | Professional | None | $302.00 | $467.74 | $870.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $4,466.84 | Facility | None | $1,202.26 | $1,479.11 | $4,466.84 |
United Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $724.44 | Professional | None | $223.87 | $338.84 | $724.44 |
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 $134.90 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $53.70 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $190.55 | $208.93 | $208.93 |
Where West Virginia sits
The same service costs 6.8 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· 26th of 51
$398
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.