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 $208.93 Median $1,548.82 Typical High $3,311.31 | Facility | None | $208.93 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $524.81 | Professional | None | $208.93 | $295.12 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $2,089.30 | Professional | None | $199.53 | $223.87 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $562.34 | Professional | None | $199.53 | $281.84 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $707.95 | Professional | None | $316.23 | $489.78 | $707.95 |
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 $177.83 Median $288.40 Typical High $660.69 | Professional | None | $177.83 | $288.40 | $660.69 |
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 $104.71 Typical High $154.88 | Professional | 52 · Reduced service | $104.71 | $104.71 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $61.66 | Professional | 53 · Discontinued | $41.69 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $147.91 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $144.54 | $147.91 | $213.80 |
Where Washington, DC sits
The same service costs 3.9 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· 33rd of 51
$288
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.