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 $2,344.23 | Facility | None | $1,412.54 | $1,412.54 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $831.76 | Professional | None | $660.69 | $794.33 | $831.76 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,023.29 Typical High $8,128.31 | Facility | None | $741.31 | $1,023.29 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,202.26 Typical High $2,238.72 | Professional | None | $691.83 | $1,202.26 | $2,238.72 |
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 $524.81 Median $741.31 Typical High $1,318.26 | Professional | None | $524.81 | $741.31 | $1,318.26 |
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 $398.11 Typical High $416.87 | Professional | 52 · Reduced service | $331.13 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $158.49 Typical High $165.96 | Professional | 53 · Discontinued | $131.83 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $630.96 | Professional | 54 · Surgery only | $501.19 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $66.07 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $588.84 |
Where West Virginia sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 34th of 51
$851
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.