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 $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $436.52 | Professional | None | $338.84 | $380.19 | $436.52 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $549.54 Typical High $870.96 | Facility | None | $34.67 | $549.54 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $1,621.81 | Professional | None | $363.08 | $467.74 | $1,621.81 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $8,128.31 | Facility | None | $151.36 | $436.52 | $8,128.31 |
United Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $1,174.90 | Professional | None | $346.74 | $549.54 | $1,174.90 |
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 $165.96 Median $190.55 Typical High $218.78 | Professional | 52 · Reduced service | $165.96 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $251.19 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $309.03 |
Where West Virginia sits
The same service costs 5.1 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· 40th of 51
$468
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.