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 $2,454.71 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,454.71 | $2,570.40 | $2,570.40 |
CareSource Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $4,073.80 | Facility | None | $34.67 | $34.67 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,890.45 Typical High $12,302.69 | Professional | None | $2,344.23 | $3,890.45 | $12,302.69 |
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 $1,778.28 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,778.28 | $2,238.72 | $3,890.45 |
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 $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,230.27 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $489.78 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,862.09 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $371.54 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,778.28 | $1,778.28 |
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· 37th of 51
$2,570
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.