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 $1,621.81 | Facility | None | $1,412.54 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $501.19 | Professional | None | $407.38 | $489.78 | $501.19 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $8,128.31 | Facility | None | $537.03 | $707.95 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $776.25 Typical High $1,659.59 | Professional | None | $478.63 | $776.25 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $16,595.87 | Facility | None | $1,202.26 | $1,479.11 | $16,595.87 |
United Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $1,071.52 | Professional | None | $354.81 | $549.54 | $1,071.52 |
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 $204.17 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $74.13 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $338.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $338.84 | $354.81 |
Where West Virginia sits
The same service costs 5.5 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· 30th of 51
$631
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.