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 $316.23 Median $316.23 Typical High $1,412.54 | Facility | None | $316.23 | $316.23 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | None | $288.40 | $288.40 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $446.68 | Professional | None | $275.42 | $302.00 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,862.09 Typical High $8,128.31 | Facility | None | $457.09 | $1,862.09 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $1,862.09 | Professional | None | $295.12 | $436.52 | $1,862.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $6,760.83 Typical High $19,054.61 | Facility | None | $4,786.30 | $6,760.83 | $19,054.61 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $16,595.87 | Facility | None | $1,202.26 | $1,479.11 | $16,595.87 |
United Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $478.63 | Professional | None | $223.87 | $288.40 | $478.63 |
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 $144.54 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | 54 · Surgery only | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $43.65 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $204.17 |
Where West Virginia sits
The same service costs 5.5 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· 36th of 51
$331
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.