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 $2,630.27 | Facility | None | $1,412.54 | $1,412.54 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $380.19 | Professional | None | $323.59 | $338.84 | $380.19 |
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 $588.84 Median $2,290.87 Typical High $4,677.35 | Facility | None | $588.84 | $2,290.87 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $2,691.53 | Professional | None | $407.38 | $512.86 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $9,120.11 | Facility | None | $1,202.26 | $1,479.11 | $9,120.11 |
United Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $954.99 | Professional | None | $302.00 | $436.52 | $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 $165.96 Median $169.82 Typical High $190.55 | Professional | 52 · Reduced service | $165.96 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | 53 · Discontinued | $67.61 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $288.40 | Professional | 54 · Surgery only | $251.19 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $239.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $234.42 | $239.88 | $269.15 |
Where West Virginia sits
The same service costs 3.8 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· 41st of 51
$457
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.