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 $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $4,073.80 | Facility | None | $34.67 | $34.67 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,981.07 Typical High $6,918.31 | Professional | None | $2,344.23 | $3,981.07 | $6,918.31 |
United Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $870.96 | Facility | None | $151.36 | $660.69 | $870.96 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $5,248.07 | Professional | None | $1,698.24 | $2,344.23 | $5,248.07 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,584.89 |
Where West Virginia sits
The same service costs 24.0 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· 29th of 51
$2,884
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.