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 $426.58 Median $436.52 Typical High $436.52 | Professional | None | $426.58 | $436.52 | $436.52 |
CareSource Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $724.44 | Facility | None | $34.67 | $34.67 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $2,187.76 | Professional | None | $436.52 | $676.08 | $2,187.76 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $1,230.27 | Facility | None | $426.58 | $660.69 | $1,230.27 |
United Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $691.83 | Professional | None | $323.59 | $426.58 | $691.83 |
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 $213.80 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $85.11 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $323.59 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $42.66 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $302.00 | $309.03 | $309.03 |
Where West Virginia sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 32nd of 51
$501
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.