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 $1,698.24 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,698.24 | $1,778.28 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $2,818.38 | Facility | None | $34.67 | $34.67 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $9,120.11 | Professional | None | $1,621.81 | $2,691.53 | $9,120.11 |
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 $1,258.93 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,621.81 | $2,691.53 |
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 $851.14 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $851.14 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,288.25 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,230.27 | $1,230.27 |
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
$1,820
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.