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 $1,737.80 | Facility | None | $1,412.54 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $1,548.82 | Professional | None | $426.58 | $489.78 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,311.31 Typical High $7,943.28 | Facility | None | $707.95 | $3,311.31 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,513.56 Typical High $12,302.69 | Professional | None | $512.86 | $1,513.56 | $12,302.69 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $14,125.38 | Facility | None | $1,698.24 | $3,162.28 | $14,125.38 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,148.15 Typical High $4,265.80 | Professional | None | $371.54 | $1,148.15 | $4,265.80 |
4 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 $323.59 Median $363.08 Typical High $1,148.15 | Professional | 54 · Surgery only | $323.59 | $363.08 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $229.09 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $48.98 Typical High $154.88 | Professional | 56 · Pre-op care only | $42.66 | $48.98 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $338.84 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $302.00 | $338.84 | $1,071.52 |
Where West Virginia sits
The same service costs 4.5 times more in Alaska than in Nebraska. 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· 45th of 51
$1,479
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.