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 $1,737.80 | Facility | None | $1,412.54 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | None | $616.60 | $630.96 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $3,890.45 | Facility | None | $602.56 | $1,071.52 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $2,951.21 | Professional | None | $602.56 | $954.99 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $7,762.47 | Facility | None | $1,202.26 | $1,479.11 | $7,762.47 |
United Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $954.99 | Professional | None | $426.58 | $549.54 | $954.99 |
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 $309.03 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $309.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $457.09 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $436.52 |
Where West Virginia sits
The same service costs 5.6 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
$646
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.