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 $2,344.23 | Facility | None | $1,412.54 | $1,412.54 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | None | $602.56 | $616.60 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $4,786.30 | Facility | None | $1,023.29 | $3,311.31 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $3,235.94 | Professional | None | $588.84 | $933.25 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $10,000.00 | Facility | None | $1,479.11 | $2,089.30 | $10,000.00 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $954.99 | Professional | None | $436.52 | $562.34 | $954.99 |
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 $302.00 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $120.23 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $457.09 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $436.52 |
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
$661
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.