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 $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
CareSource Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $6,165.95 Typical High $38,018.94 | Facility | None | $34.67 | $6,165.95 | $38,018.94 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $6,025.60 Typical High $11,481.54 | Professional | None | $3,801.89 | $6,025.60 | $11,481.54 |
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 $3,019.95 Median $4,466.84 Typical High $9,772.37 | Professional | None | $3,019.95 | $4,466.84 | $9,772.37 |
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 $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,754.23 | $2,754.23 |
Where West Virginia sits
The same service costs 20.4 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· 23rd of 51
$5,370
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.