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 $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
CareSource Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,981.07 Typical High $8,317.64 | Facility | None | $34.67 | $3,981.07 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $5,128.61 Typical High $25,703.96 | Professional | None | $3,801.89 | $5,128.61 | $25,703.96 |
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 $1,348.96 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,348.96 | $2,511.89 | $4,466.84 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,137.96 | $2,137.96 |
Where West Virginia sits
The same service costs 21.4 times more in Alaska than in Kentucky. 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
$3,090
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.