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 $2,630.27 | Facility | None | $1,412.54 | $1,412.54 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,230.27 | $1,479.11 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,862.09 Typical High $8,128.31 | Facility | None | $851.14 | $1,862.09 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $2,187.76 Typical High $7,762.47 | Professional | None | $1,318.26 | $2,187.76 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $16,595.87 | Facility | None | $1,698.24 | $3,162.28 | $16,595.87 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $3,090.30 | Professional | None | $954.99 | $1,445.44 | $3,090.30 |
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 $575.44 Median $616.60 Typical High $741.31 | Professional | 52 · Reduced service | $575.44 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $234.42 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $147.91 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $1,023.29 |
Where West Virginia sits
The same service costs 5.2 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· 32nd of 51
$1,698
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.