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 $457.09 Median $537.03 Typical High $616.60 | Professional | None | $457.09 | $537.03 | $616.60 |
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 $741.31 Median $2,290.87 Typical High $3,981.07 | Facility | None | $741.31 | $2,290.87 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $3,162.28 | Professional | None | $524.81 | $933.25 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $9,332.54 | Facility | None | $1,202.26 | $1,479.11 | $9,332.54 |
United Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $1,445.44 | Professional | None | $371.54 | $602.56 | $1,445.44 |
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 $229.09 Median $269.15 Typical High $309.03 | Professional | 52 · Reduced service | $229.09 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $107.15 Typical High $123.03 | Professional | 53 · Discontinued | $91.20 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $467.74 | Professional | 54 · Surgery only | $338.84 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $93.33 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $61.66 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $380.19 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $316.23 | $380.19 | $436.52 |
Where West Virginia sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$708
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.