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 $177.83 Median $239.88 Typical High $457.09 | Professional | None | $177.83 | $239.88 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $2,089.30 | Professional | None | $173.78 | $194.98 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $501.19 | Professional | None | $177.83 | $234.42 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $426.58 Typical High $575.44 | Professional | None | $257.04 | $426.58 | $575.44 |
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 $147.91 Median $234.42 Typical High $512.86 | Professional | None | $147.91 | $234.42 | $512.86 |
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 $123.03 | Professional | 52 · Reduced service | $89.13 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $36.31 Typical High $48.98 | Professional | 53 · Discontinued | $35.48 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | 54 · Surgery only | $134.90 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $17.78 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $169.82 |
Where Washington, DC sits
The same service costs 4.7 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
$234
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.