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 $3,630.78 | Facility | None | $1,412.54 | $1,412.54 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $758.58 | Professional | None | $616.60 | $724.44 | $758.58 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $3,090.30 | Facility | None | $1,000.00 | $1,778.28 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,187.76 | Professional | None | $676.08 | $1,174.90 | $2,187.76 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $4,365.16 | Facility | None | $426.58 | $660.69 | $4,365.16 |
United Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,513.56 | Professional | None | $501.19 | $758.58 | $1,513.56 |
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 $309.03 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $123.03 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $537.03 |
Where West Virginia sits
The same service costs 5.6 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· 30th of 51
$891
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.