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 $169.82 Median $181.97 Typical High $223.87 | Professional | None | $169.82 | $181.97 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $4,677.35 | Facility | None | $288.40 | $398.11 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $1,348.96 | Professional | None | $194.98 | $288.40 | $1,348.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Facility | None | $10,232.93 | $10,232.93 | $10,232.93 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $9,120.11 | Facility | None | $1,202.26 | $1,479.11 | $9,120.11 |
United Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $457.09 | Professional | None | $144.54 | $223.87 | $457.09 |
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 $85.11 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $85.11 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $34.67 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $147.91 Typical High $173.78 | Professional | 54 · Surgery only | $128.82 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $25.70 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.98 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $138.04 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $120.23 | $138.04 | $162.18 |
Where West Virginia sits
The same service costs 4.4 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· 43rd of 51
$240
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.