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 $1,819.70 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,819.70 | $1,862.09 | $1,862.09 |
CareSource Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $2,951.21 | Facility | None | $34.67 | $34.67 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $10,232.93 | Professional | None | $1,737.80 | $2,818.38 | $10,232.93 |
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 $1,318.26 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,698.24 | $2,818.38 |
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 $891.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $891.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $363.08 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,348.96 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $269.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,288.25 | $1,288.25 |
Where West Virginia sits
The same service costs 5.4 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· 35th of 51
$1,905
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.