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 $1,737.80 | Facility | None | $1,412.54 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $724.44 | Professional | None | $602.56 | $676.08 | $724.44 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $3,090.30 | Facility | None | $602.56 | $977.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $2,137.96 | Professional | None | $645.65 | $776.25 | $2,137.96 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $5,754.40 | Facility | None | $426.58 | $660.69 | $5,754.40 |
United Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,778.28 | Professional | None | $575.44 | $851.14 | $1,778.28 |
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 $302.00 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $302.00 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $489.78 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $109.65 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $457.09 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $457.09 | $512.86 |
Where West Virginia sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$776
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.