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 $158.49 Median $239.88 Typical High $245.47 | Professional | None | $158.49 | $239.88 | $245.47 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $263.03 Typical High $537.03 | Facility | None | $34.67 | $263.03 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $741.31 | Professional | None | $199.53 | $354.81 | $741.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $16,218.10 | Facility | None | $14,125.38 | $14,125.38 | $16,218.10 |
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 $131.83 Median $213.80 Typical High $389.05 | Professional | None | $131.83 | $213.80 | $389.05 |
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 $79.43 Median $100.00 Typical High $123.03 | Professional | 52 · Reduced service | $79.43 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $39.81 Typical High $48.98 | Professional | 53 · Discontinued | $31.62 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $117.49 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.20 Typical High $37.15 | Professional | 55 · Aftercare only | $23.99 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.95 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.85 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $169.82 |
Where West Virginia sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 38th of 51
$234
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.