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 $151.36 Median $1,548.82 Typical High $3,311.31 | Facility | None | $151.36 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $380.19 | Professional | None | $147.91 | $194.98 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $1,584.89 | Professional | None | $144.54 | $158.49 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $407.38 | Professional | None | $144.54 | $186.21 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $467.74 | Professional | None | $204.17 | $354.81 | $467.74 |
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 $120.23 Median $190.55 Typical High $416.87 | Professional | None | $120.23 | $190.55 | $416.87 |
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 $72.44 Median $75.86 Typical High $100.00 | Professional | 52 · Reduced service | $72.44 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.20 Typical High $40.74 | Professional | 53 · Discontinued | $29.51 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $109.65 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $21.88 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.79 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $104.71 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $102.33 | $104.71 | $141.25 |
Where Washington, DC sits
The same service costs 3.9 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· 36th of 51
$186
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.