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 $2,344.23 | Facility | None | $1,412.54 | $1,412.54 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
CareSource Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $537.03 Typical High $12,589.25 | Facility | None | $34.67 | $537.03 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $5,754.40 Typical High $9,332.54 | Professional | None | $3,715.35 | $5,754.40 | $9,332.54 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $20,417.38 | Facility | None | $1,698.24 | $3,162.28 | $20,417.38 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $4,265.80 Typical High $8,912.51 | Professional | None | $2,818.38 | $4,265.80 | $8,912.51 |
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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,630.27 | $2,630.27 |
Where West Virginia sits
The same service costs 20.4 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· 25th of 51
$4,677
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.