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 $194.98 Median $245.47 Typical High $309.03 | Professional | None | $194.98 | $245.47 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $309.03 Typical High $660.69 | Facility | None | $34.67 | $309.03 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $724.44 | Professional | None | $245.47 | $457.09 | $724.44 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $6,606.93 | Facility | None | $1,202.26 | $1,479.11 | $6,606.93 |
United Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $588.84 | Professional | None | $158.49 | $288.40 | $588.84 |
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 $97.72 Median $123.03 Typical High $154.88 | Professional | 52 · Reduced service | $97.72 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $38.90 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $186.21 Typical High $234.42 | Professional | 54 · Surgery only | $144.54 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $46.77 | Professional | 55 · Aftercare only | $28.84 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $173.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $134.90 | $173.78 | $218.78 |
Where West Virginia sits
The same service costs 4.3 times more in Wyoming 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· 37th of 51
$309
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.