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 $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,412.54 Typical High $4,466.84 | Facility | None | $602.56 | $1,412.54 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,089.30 | Professional | None | $831.76 | $1,230.27 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $9,120.11 | Facility | None | $1,479.11 | $2,089.30 | $9,120.11 |
United Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $1,778.28 | Professional | None | $588.84 | $933.25 | $1,778.28 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $575.44 |
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· 27th of 51
$1,096
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.