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 $338.84 Median $398.11 Typical High $549.54 | Professional | None | $338.84 | $398.11 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $3,162.28 | Facility | None | $537.03 | $602.56 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $1,445.44 | Professional | None | $446.68 | $831.76 | $1,445.44 |
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 $263.03 Median $436.52 Typical High $912.01 | Professional | None | $263.03 | $436.52 | $912.01 |
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 $165.96 Median $199.53 Typical High $275.42 | Professional | 52 · Reduced service | $165.96 | $199.53 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $81.28 Typical High $109.65 | Professional | 53 · Discontinued | $67.61 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $302.00 Typical High $407.38 | Professional | 54 · Surgery only | $251.19 | $302.00 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $81.28 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $39.81 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.88 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $281.84 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $234.42 | $281.84 | $380.19 |
Where West Virginia sits
The same service costs 4.7 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· 36th of 51
$525
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.