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 $1,318.26 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,548.82 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,089.30 Typical High $2,238.72 | Facility | None | $34.67 | $2,089.30 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,454.71 Typical High $5,248.07 | Professional | None | $1,412.54 | $2,454.71 | $5,248.07 |
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 $1,122.02 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,122.02 | $1,949.84 | $3,801.89 |
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 $660.69 Median $758.58 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $309.03 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $229.09 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $154.88 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $1,071.52 | $1,122.02 |
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
$1,995
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.