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 $2,630.27 | Facility | None | $1,412.54 | $1,412.54 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $8,128.31 | Facility | None | $851.14 | $1,174.90 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $3,311.31 | Professional | None | $707.95 | $1,071.52 | $3,311.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Facility | None | $12,882.50 | $12,882.50 | $12,882.50 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $16,595.87 | Facility | None | $1,698.24 | $3,162.28 | $16,595.87 |
United Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,288.25 | Professional | None | $562.34 | $707.95 | $1,288.25 |
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 $354.81 Median $354.81 Typical High $363.08 | Professional | 52 · Reduced service | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
Where West Virginia sits
The same service costs 6.2 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· 30th of 51
$851
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.