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 $245.47 Median $295.12 Typical High $323.59 | Facility | None | $245.47 | $295.12 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $323.59 | Professional | None | $223.87 | $295.12 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $537.03 Typical High $1,778.28 | Facility | None | $354.81 | $537.03 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $812.83 | Professional | None | $251.19 | $436.52 | $812.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $18,197.01 | Facility | None | $2,570.40 | $2,570.40 | $18,197.01 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $4,365.16 | Facility | None | $426.58 | $660.69 | $4,365.16 |
United Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $467.74 | Professional | None | $177.83 | $257.04 | $467.74 |
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 $112.20 Median $134.90 Typical High $147.91 | Professional | 52 · Reduced service | $112.20 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $44.67 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $165.96 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $186.21 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $154.88 | $186.21 | $204.17 |
Where West Virginia sits
The same service costs 4.3 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· 35th of 51
$295
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.