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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
CareSource Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,548.13 Typical High $8,128.31 | Facility | None | $34.67 | $3,548.13 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,311.31 Typical High $5,495.41 | Professional | None | $2,187.76 | $3,311.31 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $16,595.87 | Facility | None | $1,698.24 | $3,162.28 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $4,677.35 | Professional | None | $1,548.82 | $2,137.96 | $4,677.35 |
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,548.82 |
Where West Virginia sits
The same service costs 21.4 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· 31st of 51
$2,570
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.