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 $239.88 Median $338.84 Typical High $363.08 | Professional | None | $239.88 | $338.84 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $645.65 Typical High $1,862.09 | Facility | None | $416.87 | $645.65 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $1,047.13 | Professional | None | $295.12 | $549.54 | $1,047.13 |
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 $199.53 Median $346.74 Typical High $630.96 | Professional | None | $199.53 | $346.74 | $630.96 |
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 $120.23 Median $144.54 Typical High $177.83 | Professional | 52 · Reduced service | $120.23 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $57.54 Typical High $72.44 | Professional | 53 · Discontinued | $47.86 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $213.80 Typical High $269.15 | Professional | 54 · Surgery only | $181.97 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $43.65 Typical High $53.70 | Professional | 55 · Aftercare only | $36.31 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.84 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.99 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $199.53 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $169.82 | $199.53 | $251.19 |
Where West Virginia sits
The same service costs 4.3 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· 33rd of 51
$372
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.