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 $2,630.27 | Facility | None | $1,412.54 | $1,412.54 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | None | $758.58 | $776.25 | $776.25 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,288.25 Typical High $8,317.64 | Facility | None | $34.67 | $1,288.25 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $4,365.16 | Professional | None | $741.31 | $1,202.26 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $4,073.80 Typical High $16,982.44 | Facility | None | $1,905.46 | $4,073.80 | $16,982.44 |
United Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,230.27 | Professional | None | $562.34 | $758.58 | $1,230.27 |
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 $380.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $380.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $575.44 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $75.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $537.03 | $549.54 | $549.54 |
Where West Virginia sits
The same service costs 25.1 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· 32nd of 51
$871
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.