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 $331.13 Median $912.01 Typical High $4,265.80 | Facility | None | $331.13 | $912.01 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $794.33 | Professional | None | $245.47 | $323.59 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $2,089.30 | Professional | None | $239.88 | $269.15 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $676.08 | Professional | None | $239.88 | $309.03 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $758.58 | Professional | None | $354.81 | $588.84 | $758.58 |
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 $190.55 Median $316.23 Typical High $691.83 | Professional | None | $190.55 | $316.23 | $691.83 |
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 $123.03 Median $125.89 Typical High $165.96 | Professional | 52 · Reduced service | $123.03 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $66.07 | Professional | 53 · Discontinued | $50.12 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $33.11 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $177.83 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $173.78 | $177.83 | $229.09 |
Where Washington, DC sits
The same service costs 4.8 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· 37th of 51
$309
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.