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 $275.42 Median $389.05 Typical High $407.38 | Professional | None | $275.42 | $389.05 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $741.31 Typical High $1,659.59 | Facility | None | $467.74 | $741.31 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $616.60 Typical High $1,148.15 | Professional | None | $338.84 | $616.60 | $1,148.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
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 $389.05 Typical High $724.44 | Professional | None | $223.87 | $389.05 | $724.44 |
7 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 $162.18 Typical High $204.17 | Professional | 52 · Reduced service | $138.04 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $66.07 Typical High $81.28 | Professional | 53 · Discontinued | $54.95 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $302.00 | Professional | 54 · Surgery only | $204.17 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $60.26 | Professional | 55 · Aftercare only | $40.74 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.11 Typical High $40.74 | Professional | 56 · Pre-op care only | $27.54 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $229.09 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $190.55 | $229.09 | $281.84 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 59 · Distinct service | $371.54 | $371.54 | $371.54 |
Where West Virginia sits
The same service costs 4.7 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
$427
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.