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 $194.98 Median $1,548.82 Typical High $3,311.31 | Facility | None | $194.98 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $489.78 | Professional | None | $190.55 | $281.84 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $1,380.38 | Professional | None | $194.98 | $213.80 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $524.81 | Professional | None | $186.21 | $269.15 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $676.08 | Professional | None | $295.12 | $457.09 | $676.08 |
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 $165.96 Median $269.15 Typical High $616.60 | Professional | None | $165.96 | $269.15 | $616.60 |
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 $95.50 Median $97.72 Typical High $144.54 | Professional | 52 · Reduced service | $95.50 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.90 Typical High $57.54 | Professional | 53 · Discontinued | $38.02 | $38.90 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $218.78 | Professional | 54 · Surgery only | $144.54 | $144.54 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $28.84 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.50 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.05 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $204.17 |
Where Washington, DC sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$269
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.