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 $208.93 Median $257.04 Typical High $2,137.96 | Professional | None | $208.93 | $257.04 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $354.81 Typical High $2,691.53 | Facility | None | $34.67 | $354.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $1,778.28 Typical High $4,073.80 | Professional | None | $281.84 | $1,778.28 | $4,073.80 |
United Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $5,888.44 | Facility | None | $426.58 | $660.69 | $5,888.44 |
United Setting Professional Modifier None Typical Low $204.17 Median $1,230.27 Typical High $3,467.37 | Professional | None | $204.17 | $1,230.27 | $3,467.37 |
2 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 54 · Surgery only Typical Low $154.88 Median $190.55 Typical High $1,621.81 | Professional | 54 · Surgery only | $154.88 | $190.55 | $1,621.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $177.83 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $144.54 | $177.83 | $1,513.56 |
Where West Virginia sits
The same service costs 7.1 times more in Oregon 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· 41st of 51
$1,230
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.