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 $1,348.96 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,348.96 | $1,380.38 | $1,380.38 |
CareSource Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $2,238.72 | Facility | None | $34.67 | $34.67 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $7,079.46 | Professional | None | $1,318.26 | $2,089.30 | $7,079.46 |
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 $977.24 Median $1,258.93 Typical High $2,137.96 | Professional | None | $977.24 | $1,258.93 | $2,137.96 |
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 $676.08 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $676.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $977.24 |
Where West Virginia sits
The same service costs 5.4 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· 38th of 51
$1,413
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.