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 $257.04 Median $295.12 Typical High $338.84 | Professional | None | $257.04 | $295.12 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $489.78 Typical High $2,187.76 | Facility | None | $407.38 | $489.78 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $1,862.09 | Professional | None | $331.13 | $436.52 | $1,862.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $208.93 Median $575.44 Typical High $1,318.26 | Professional | None | $208.93 | $575.44 | $1,318.26 |
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 $128.82 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $51.29 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $218.78 Typical High $251.19 | Professional | 54 · Surgery only | $190.55 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $43.65 Typical High $50.12 | Professional | 55 · Aftercare only | $38.02 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.70 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $204.17 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $177.83 | $204.17 | $234.42 |
Where West Virginia sits
The same service costs 5.0 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· 29th of 51
$437
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.