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 $1,737.80 | Facility | None | $1,412.54 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $891.25 | Professional | None | $660.69 | $691.83 | $891.25 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $8,128.31 | Facility | None | $602.56 | $954.99 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,348.96 Typical High $4,073.80 | Professional | None | $676.08 | $1,348.96 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $16,595.87 | Facility | None | $1,202.26 | $1,479.11 | $16,595.87 |
United Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $1,778.28 | Professional | None | $537.03 | $851.14 | $1,778.28 |
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 $331.13 Median $346.74 Typical High $446.68 | Professional | 52 · Reduced service | $331.13 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $177.83 | Professional | 53 · Discontinued | $131.83 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $676.08 | Professional | 54 · Surgery only | $501.19 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $134.90 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $630.96 |
Where West Virginia sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 35th of 51
$955
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.