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 $257.04 Median $323.59 Typical High $363.08 | Professional | None | $257.04 | $323.59 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $436.52 Typical High $724.44 | Facility | None | $34.67 | $436.52 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $1,047.13 | Professional | None | $316.23 | $549.54 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $9,332.54 | Facility | None | $1,202.26 | $1,479.11 | $9,332.54 |
United Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $660.69 | Professional | None | $213.80 | $346.74 | $660.69 |
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 $128.82 Median $162.18 Typical High $181.97 | Professional | 52 · Reduced service | $128.82 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $64.57 Typical High $72.44 | Professional | 53 · Discontinued | $51.29 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $194.98 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $48.98 Typical High $53.70 | Professional | 55 · Aftercare only | $38.90 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $32.36 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $229.09 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $181.97 | $229.09 | $251.19 |
Where West Virginia sits
The same service costs 4.8 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· 32nd of 51
$398
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.