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 $239.88 Median $239.88 Typical High $269.15 | Professional | None | $239.88 | $239.88 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $741.31 Typical High $3,981.07 | Facility | None | $389.05 | $741.31 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $1,621.81 | Professional | None | $245.47 | $363.08 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $9,332.54 | Facility | None | $1,202.26 | $1,479.11 | $9,332.54 |
United Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $416.87 | Professional | None | $190.55 | $239.88 | $416.87 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 53 · Discontinued | $47.86 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 54 · Surgery only | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $169.82 |
Where West Virginia sits
The same service costs 6.0 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
$282
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.