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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $114.82 | Professional | None | $83.18 | $102.33 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $144.54 Typical High $223.87 | Facility | None | $34.67 | $144.54 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $281.84 | Professional | None | $104.71 | $177.83 | $281.84 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $4,365.16 | Facility | None | $426.58 | $660.69 | $4,365.16 |
United Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $257.04 | Professional | None | $67.61 | $125.89 | $257.04 |
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 $41.69 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $41.69 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $16.60 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $75.86 Typical High $85.11 | Professional | 54 · Surgery only | $63.10 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $12.59 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.32 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $70.79 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $58.88 | $70.79 | $79.43 |
Where West Virginia sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 33rd of 51
$132
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.