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 $478.63 Typical High $3,311.31 | Facility | None | $181.97 | $478.63 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $309.03 | Professional | None | $117.49 | $177.83 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $1,584.89 | Professional | None | $112.20 | $125.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $316.23 | Professional | None | $112.20 | $165.96 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $416.87 | Professional | None | $181.97 | $275.42 | $416.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $363.08 | Professional | None | $100.00 | $162.18 | $363.08 |
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 $57.54 Median $58.88 Typical High $89.13 | Professional | 52 · Reduced service | $57.54 | $58.88 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.44 Typical High $36.31 | Professional | 53 · Discontinued | $22.91 | $23.44 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $89.13 Typical High $134.90 | Professional | 54 · Surgery only | $87.10 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.78 Typical High $26.92 | Professional | 55 · Aftercare only | $17.38 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.75 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.48 | $11.75 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $83.18 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $81.28 | $83.18 | $125.89 |
Where Washington, DC sits
The same service costs 3.8 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
$166
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.