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 $169.82 Median $1,548.82 Typical High $3,311.31 | Facility | None | $169.82 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $416.87 | Professional | None | $165.96 | $229.09 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $2,089.30 | Professional | None | $158.49 | $177.83 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $457.09 | Professional | None | $162.18 | $218.78 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $537.03 | Professional | None | $245.47 | $389.05 | $537.03 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $478.63 | Professional | None | $134.90 | $218.78 | $478.63 |
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 $83.18 Median $83.18 Typical High $117.49 | Professional | 52 · Reduced service | $83.18 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $46.77 | Professional | 53 · Discontinued | $33.11 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $125.89 Typical High $173.78 | Professional | 54 · Surgery only | $123.03 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.12 Typical High $35.48 | Professional | 55 · Aftercare only | $24.55 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $117.49 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $114.82 | $117.49 | $162.18 |
Where Washington, DC sits
The same service costs 4.6 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
$219
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.