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 $478.63 Median $478.63 Typical High $489.78 | Professional | None | $478.63 | $478.63 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $758.58 Typical High $8,128.31 | Facility | None | $602.56 | $758.58 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $2,754.23 | Professional | None | $478.63 | $741.31 | $2,754.23 |
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 $389.05 Median $501.19 Typical High $851.14 | Professional | None | $389.05 | $501.19 | $851.14 |
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 $239.88 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $338.84 |
Where West Virginia sits
The same service costs 6.3 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· 31st of 51
$575
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.