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 $1,621.81 | Facility | None | $1,412.54 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $537.03 Median $1,047.13 Typical High $2,344.23 | Facility | None | $537.03 | $1,047.13 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,737.80 | Professional | None | $616.60 | $954.99 | $1,737.80 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $4,466.84 | Facility | None | $426.58 | $660.69 | $4,466.84 |
United Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $1,047.13 | Professional | None | $407.38 | $562.34 | $1,047.13 |
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 $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $436.52 |
Where West Virginia sits
The same service costs 7.4 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· 32nd of 51
$708
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.