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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $239.88 | Professional | None | $151.36 | $181.97 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $251.19 Typical High $512.86 | Facility | None | $34.67 | $251.19 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $660.69 | Professional | None | $204.17 | $363.08 | $660.69 |
United Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $4,570.88 | Facility | None | $151.36 | $436.52 | $4,570.88 |
United Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $398.11 | Professional | None | $125.89 | $204.17 | $398.11 |
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 $75.86 Median $91.20 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $36.31 Typical High $48.98 | Professional | 53 · Discontinued | $30.20 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $134.90 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $27.54 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $18.20 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $125.89 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $125.89 | $169.82 |
Where West Virginia sits
The same service costs 3.5 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· 36th of 51
$240
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.