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 $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,148.15 | $1,174.90 | $1,174.90 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $1,905.46 | Facility | None | $34.67 | $34.67 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $5,888.44 | Professional | None | $1,122.02 | $1,778.28 | $5,888.44 |
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 $831.76 Median $1,047.13 Typical High $1,819.70 | Professional | None | $831.76 | $1,047.13 | $1,819.70 |
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 $575.44 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $575.44 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $870.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $114.82 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $812.83 | $831.76 | $831.76 |
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· 36th of 51
$1,202
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.