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 $213.80 Median $2,818.38 Typical High $4,786.30 | Facility | None | $213.80 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $537.03 | Professional | None | $208.93 | $309.03 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $1,584.89 | Professional | None | $204.17 | $223.87 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $575.44 | Professional | None | $204.17 | $295.12 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $741.31 | Professional | None | $331.13 | $501.19 | $741.31 |
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 $181.97 Median $302.00 Typical High $691.83 | Professional | None | $181.97 | $302.00 | $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 $104.71 Median $107.15 Typical High $162.18 | Professional | 52 · Reduced service | $104.71 | $107.15 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $64.57 | Professional | 53 · Discontinued | $42.66 | $42.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $162.18 Typical High $239.88 | Professional | 54 · Surgery only | $158.49 | $162.18 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $32.36 | Professional | 56 · Pre-op care only | $20.89 | $21.38 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $151.36 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $147.91 | $151.36 | $223.87 |
Where Washington, DC sits
The same service costs 3.6 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· 35th of 51
$302
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.