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 $125.89 Median $194.98 Typical High $218.78 | Professional | None | $125.89 | $194.98 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $204.17 Typical High $457.09 | Facility | None | $34.67 | $204.17 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $562.34 | Professional | None | $158.49 | $295.12 | $562.34 |
Highmark BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Facility | None | $6,760.83 | $6,760.83 | $6,760.83 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $9,332.54 | Facility | None | $426.58 | $660.69 | $9,332.54 |
United Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $295.12 | Professional | None | $100.00 | $165.96 | $295.12 |
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 $63.10 Median $79.43 Typical High $109.65 | Professional | 52 · Reduced service | $63.10 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $25.12 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $162.18 | Professional | 54 · Surgery only | $93.33 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $32.36 | Professional | 55 · Aftercare only | $18.62 | $23.99 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.59 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $112.20 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $87.10 | $112.20 | $151.36 |
Where West Virginia sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 37th of 51
$191
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.