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 $1,621.81 | Facility | None | $1,412.54 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $1,318.26 | Professional | None | $354.81 | $426.58 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $616.60 Typical High $3,235.94 | Facility | None | $34.67 | $616.60 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,862.09 Typical High $19,054.61 | Professional | None | $489.78 | $1,862.09 | $19,054.61 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $9,772.37 | Facility | None | $1,698.24 | $3,162.28 | $9,772.37 |
United Setting Professional Modifier None Typical Low $354.81 Median $1,380.38 Typical High $5,623.41 | Professional | None | $354.81 | $1,380.38 | $5,623.41 |
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 $177.83 Median $213.80 Typical High $660.69 | Professional | 52 · Reduced service | $177.83 | $213.80 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $85.11 Typical High $263.03 | Professional | 53 · Discontinued | $70.79 | $85.11 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $316.23 Typical High $977.24 | Professional | 54 · Surgery only | $263.03 | $316.23 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $194.98 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $131.83 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $295.12 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $245.47 | $295.12 | $912.01 |
Where West Virginia sits
The same service costs 4.9 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· 30th of 51
$1,445
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.