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 $295.12 Median $398.11 Typical High $426.58 | Professional | None | $295.12 | $398.11 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $501.19 Typical High $758.58 | Facility | None | $34.67 | $501.19 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $645.65 Typical High $1,202.26 | Professional | None | $354.81 | $645.65 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $4,466.84 | Facility | None | $1,202.26 | $1,479.11 | $4,466.84 |
United Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $758.58 | Professional | None | $239.88 | $398.11 | $758.58 |
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 $147.91 Median $173.78 Typical High $213.80 | Professional | 52 · Reduced service | $147.91 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $70.79 Typical High $85.11 | Professional | 53 · Discontinued | $58.88 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $263.03 Typical High $316.23 | Professional | 54 · Surgery only | $218.78 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $43.65 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $29.51 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $245.47 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $204.17 | $245.47 | $295.12 |
Where West Virginia sits
The same service costs 4.5 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· 31st of 51
$457
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.