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 $245.47 Median $323.59 Typical High $346.74 | Professional | None | $245.47 | $323.59 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $426.58 Typical High $707.95 | Facility | None | $34.67 | $426.58 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $1,071.52 | Professional | None | $309.03 | $524.81 | $1,071.52 |
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 $645.65 | Professional | None | $213.80 | $346.74 | $645.65 |
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 $123.03 Median $162.18 Typical High $173.78 | Professional | 52 · Reduced service | $123.03 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $48.98 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $186.21 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $37.15 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $24.55 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $223.87 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $173.78 | $223.87 | $245.47 |
Where West Virginia sits
The same service costs 5.2 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
$380
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.