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 $323.59 Median $363.08 Typical High $426.58 | Professional | None | $323.59 | $363.08 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $549.54 | Facility | None | $34.67 | $34.67 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $1,258.93 | Professional | None | $354.81 | $457.09 | $1,258.93 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $1,148.15 | Facility | None | $100.00 | $131.83 | $1,148.15 |
United Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $977.24 | Professional | None | $295.12 | $457.09 | $977.24 |
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 $162.18 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $162.18 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $64.57 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $239.88 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $32.36 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $302.00 |
Where West Virginia sits
The same service costs 4.7 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· 31st 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.