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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $229.09 | Professional | None | $131.83 | $204.17 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $229.09 Typical High $537.03 | Facility | None | $34.67 | $229.09 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $316.23 Typical High $630.96 | Professional | None | $169.82 | $316.23 | $630.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $1,148.15 | Facility | None | $100.00 | $131.83 | $1,148.15 |
United Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $309.03 | Professional | None | $107.15 | $177.83 | $309.03 |
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 $66.07 Median $87.10 Typical High $112.20 | Professional | 52 · Reduced service | $66.07 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $34.67 Typical High $45.71 | Professional | 53 · Discontinued | $26.92 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $128.82 Typical High $169.82 | Professional | 54 · Surgery only | $100.00 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.70 Typical High $33.88 | Professional | 55 · Aftercare only | $19.95 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $17.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $13.18 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $120.23 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $93.33 | $120.23 | $158.49 |
Where West Virginia sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 39th of 51
$204
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.