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 $467.74 Median $512.86 Typical High $645.65 | Professional | None | $467.74 | $512.86 | $645.65 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $741.31 Typical High $794.33 | Facility | None | $34.67 | $741.31 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,348.96 | Professional | None | $537.03 | $758.58 | $1,348.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Highmark BCBS Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $831.76 | Professional | None | $691.83 | $776.25 | $831.76 |
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 $380.19 Median $645.65 Typical High $1,412.54 | Professional | None | $380.19 | $645.65 | $1,412.54 |
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 $234.42 Median $257.04 Typical High $288.40 | Professional | 52 · Reduced service | $234.42 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $93.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $346.74 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $46.77 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $407.38 |
Where West Virginia sits
The same service costs 6.2 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· 26th of 51
$676
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.