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 $3,630.78 | Facility | None | $1,412.54 | $1,412.54 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | None | $776.25 | $794.33 | $794.33 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $1,288.25 | Facility | None | $34.67 | $34.67 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $4,466.84 | Professional | None | $758.58 | $1,202.26 | $4,466.84 |
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 $575.44 Median $758.58 Typical High $1,258.93 | Professional | None | $575.44 | $758.58 | $1,258.93 |
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 $389.05 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $562.34 |
Where West Virginia sits
The same service costs 5.9 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· 34th of 51
$871
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.