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 $281.84 Median $316.23 Typical High $389.05 | Professional | None | $281.84 | $316.23 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $537.03 Typical High $4,677.35 | Facility | None | $457.09 | $537.03 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $575.44 Typical High $1,905.46 | Professional | None | $316.23 | $575.44 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $9,772.37 | Facility | None | $1,202.26 | $1,479.11 | $9,772.37 |
United Setting Professional Modifier None Typical Low $239.88 Median $446.68 Typical High $1,174.90 | Professional | None | $239.88 | $446.68 | $1,174.90 |
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 $138.04 Median $158.49 Typical High $194.98 | Professional | 52 · Reduced service | $138.04 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $63.10 Typical High $77.62 | Professional | 53 · Discontinued | $56.23 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $288.40 | Professional | 54 · Surgery only | $208.93 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $38.90 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $269.15 |
Where West Virginia sits
The same service costs 4.8 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· 40th of 51
$447
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.