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 $295.12 Median $2,818.38 Typical High $4,786.30 | Facility | None | $295.12 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $724.44 | Professional | None | $288.40 | $407.38 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $3,235.94 | Professional | None | $275.42 | $309.03 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $776.25 | Professional | None | $275.42 | $389.05 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $977.24 | Professional | None | $446.68 | $676.08 | $977.24 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $891.25 | Professional | None | $251.19 | $389.05 | $891.25 |
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 $144.54 Median $144.54 Typical High $208.93 | Professional | 52 · Reduced service | $144.54 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $58.88 Typical High $83.18 | Professional | 53 · Discontinued | $57.54 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $316.23 | Professional | 54 · Surgery only | $218.78 | $218.78 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $63.10 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $29.51 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.84 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $295.12 |
Where Washington, DC sits
The same service costs 4.3 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· 41st of 51
$389
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.