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 $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $4,265.80 Typical High $38,018.94 | Facility | None | $34.67 | $4,265.80 | $38,018.94 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $6,918.31 | Professional | None | $2,630.27 | $4,168.69 | $6,918.31 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $8,511.38 Typical High $48,977.88 | Facility | None | $3,981.07 | $8,511.38 | $48,977.88 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $5,888.44 | Professional | None | $1,949.84 | $2,691.53 | $5,888.44 |
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $2,041.74 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,905.46 | $1,905.46 |
Where West Virginia sits
The same service costs 20.0 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· 29th of 51
$3,311
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.