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 $131.83 Median $354.81 Typical High $3,311.31 | Facility | None | $131.83 | $354.81 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $323.59 | Professional | None | $104.71 | $131.83 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $645.65 | Professional | None | $97.72 | $109.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $295.12 | Professional | None | $107.15 | $128.82 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $309.03 | Professional | None | $134.90 | $245.47 | $309.03 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $295.12 | Professional | None | $77.62 | $123.03 | $295.12 |
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 $52.48 Median $53.70 Typical High $64.57 | Professional | 52 · Reduced service | $52.48 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $26.30 | Professional | 53 · Discontinued | $20.89 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $81.28 Typical High $97.72 | Professional | 54 · Surgery only | $79.43 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $19.50 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $75.86 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $74.13 | $75.86 | $91.20 |
Where Washington, DC sits
The same service costs 4.4 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.
Washington, DC· 32nd of 51
$129
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.