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 Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,348.96 | $1,380.38 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,862.09 Typical High $1,949.84 | Facility | None | $34.67 | $1,862.09 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $4,677.35 | Professional | None | $1,258.93 | $2,137.96 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,698.24 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,000.00 | $1,737.80 | $3,388.44 |
5 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 $575.44 Median $676.08 Typical High $691.83 | Professional | 52 · Reduced service | $575.44 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $269.15 Typical High $281.84 | Professional | 53 · Discontinued | $229.09 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $138.04 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $977.24 |
Where West Virginia sits
The same service costs 5.1 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· 27th of 51
$1,778
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.