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 $1,621.81 | Facility | None | $1,412.54 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $436.52 | Professional | None | $302.00 | $407.38 | $436.52 |
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 $512.86 Median $537.03 Typical High $1,995.26 | Facility | None | $512.86 | $537.03 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $660.69 Typical High $1,258.93 | Professional | None | $363.08 | $660.69 | $1,258.93 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $10,964.78 | Facility | None | $7,079.46 | $7,079.46 | $10,964.78 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $4,570.88 | Facility | None | $426.58 | $660.69 | $4,570.88 |
United Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $776.25 | Professional | None | $245.47 | $416.87 | $776.25 |
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 $151.36 Median $177.83 Typical High $218.78 | Professional | 52 · Reduced service | $151.36 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $70.79 Typical High $87.10 | Professional | 53 · Discontinued | $60.26 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $223.87 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $44.67 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $30.20 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $208.93 | $251.19 | $302.00 |
Where West Virginia sits
The same service costs 4.9 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· 33rd of 51
$457
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.