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 $181.97 Median $2,818.38 Typical High $4,786.30 | Facility | None | $181.97 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $691.83 | Professional | None | $181.97 | $275.42 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $2,570.40 | Professional | None | $173.78 | $194.98 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $489.78 | Professional | None | $186.21 | $263.03 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $630.96 | Professional | None | $309.03 | $426.58 | $630.96 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $549.54 | Professional | None | $154.88 | $245.47 | $549.54 |
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 $89.13 Median $91.20 Typical High $138.04 | Professional | 52 · Reduced service | $89.13 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $54.95 | Professional | 53 · Discontinued | $36.31 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $138.04 Typical High $208.93 | Professional | 54 · Surgery only | $134.90 | $138.04 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $27.54 Typical High $41.69 | Professional | 55 · Aftercare only | $26.92 | $27.54 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $128.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $125.89 | $128.82 | $194.98 |
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· 37th of 51
$257
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.