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 $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,818.38 | $2,951.21 | $2,951.21 |
CareSource Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $4,786.30 | Facility | None | $34.67 | $34.67 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $4,466.84 Typical High $12,882.50 | Professional | None | $2,691.53 | $4,466.84 | $12,882.50 |
United Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $870.96 | Facility | None | $151.36 | $660.69 | $870.96 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $4,466.84 | Professional | None | $1,995.26 | $2,398.83 | $4,466.84 |
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 $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,412.54 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $562.34 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,137.96 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $426.58 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $281.84 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,041.74 | $2,041.74 |
Where West Virginia sits
The same service costs 5.1 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· 37th of 51
$2,951
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.