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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | None | $93.33 | $107.15 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $177.83 Typical High $229.09 | Facility | None | $34.67 | $177.83 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $302.00 | Professional | None | $114.82 | $173.78 | $302.00 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $691.83 | Facility | None | $100.00 | $131.83 | $691.83 |
United Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $229.09 | Professional | None | $77.62 | $114.82 | $229.09 |
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 $46.77 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $46.77 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $18.62 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | 54 · Surgery only | $69.18 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $13.80 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.33 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $74.13 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $64.57 | $74.13 | $74.13 |
Where West Virginia sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 30th of 51
$138
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.