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 $1,737.80 | Facility | None | $1,412.54 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $426.58 | Professional | None | $316.23 | $380.19 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $602.56 Typical High $3,981.07 | Facility | None | $512.86 | $602.56 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $1,148.15 | Professional | None | $371.54 | $645.65 | $1,148.15 |
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 $251.19 Median $380.19 Typical High $724.44 | Professional | None | $251.19 | $380.19 | $724.44 |
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 $158.49 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $158.49 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $75.86 Typical High $85.11 | Professional | 53 · Discontinued | $63.10 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $239.88 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $31.62 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $223.87 | $263.03 | $295.12 |
Where West Virginia sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$468
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.