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 $229.09 Median $275.42 Typical High $371.54 | Professional | None | $229.09 | $275.42 | $371.54 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $338.84 | Professional | None | $257.04 | $263.03 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $354.81 Typical High $524.81 | Facility | None | $34.67 | $354.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $758.58 | Professional | None | $288.40 | $436.52 | $758.58 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $3,311.31 | Facility | None | $1,380.38 | $1,737.80 | $3,311.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $537.03 | Professional | None | $354.81 | $398.11 | $537.03 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $1,548.82 | Facility | None | $151.36 | $436.52 | $1,548.82 |
United Setting Professional Modifier None Typical Low $190.55 Median $389.05 Typical High $831.76 | Professional | None | $190.55 | $389.05 | $831.76 |
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 $117.49 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $117.49 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $52.48 Typical High $58.88 | Professional | 53 · Discontinued | $46.77 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $199.53 Typical High $223.87 | Professional | 54 · Surgery only | $173.78 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $39.81 Typical High $44.67 | Professional | 55 · Aftercare only | $35.48 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.30 Typical High $29.51 | Professional | 56 · Pre-op care only | $23.44 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $186.21 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $162.18 | $186.21 | $208.93 |
Where West Virginia sits
The same service costs 4.2 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· 33rd of 51
$355
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.