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 $2,884.03 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,884.03 | $2,951.21 | $2,951.21 |
CareSource Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $2,818.38 Median $4,466.84 Typical High $16,595.87 | Professional | None | $2,818.38 | $4,466.84 | $16,595.87 |
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 $2,089.30 Median $2,754.23 Typical High $4,570.88 | Professional | None | $2,089.30 | $2,754.23 | $4,570.88 |
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 $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,445.44 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $575.44 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,187.76 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $436.52 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $288.40 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,089.30 | $2,089.30 |
Where West Virginia sits
The same service costs 21.4 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· 34th of 51
$3,162
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.