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 $239.88 Median $302.00 Typical High $363.08 | Professional | None | $239.88 | $302.00 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $346.74 Typical High $660.69 | Facility | None | $34.67 | $346.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $549.54 Typical High $933.25 | Professional | None | $288.40 | $549.54 | $933.25 |
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 $186.21 Median $309.03 Typical High $645.65 | Professional | None | $186.21 | $309.03 | $645.65 |
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 $117.49 Median $151.36 Typical High $181.97 | Professional | 52 · Reduced service | $117.49 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $177.83 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $44.67 Typical High $54.95 | Professional | 55 · Aftercare only | $35.48 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.20 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.99 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $165.96 | $208.93 | $257.04 |
Where West Virginia sits
The same service costs 3.9 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· 39th of 51
$355
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.