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 $102.33 Median $1,698.24 Typical High $4,073.80 | Facility | None | $102.33 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $281.84 | Professional | None | $102.33 | $181.97 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $1,380.38 | Professional | None | $104.71 | $117.49 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $295.12 | Professional | None | $114.82 | $186.21 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $446.68 | Professional | None | $199.53 | $257.04 | $446.68 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $457.09 | Professional | None | $107.15 | $186.21 | $457.09 |
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 $50.12 Median $51.29 Typical High $89.13 | Professional | 52 · Reduced service | $50.12 | $51.29 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.42 Typical High $36.31 | Professional | 53 · Discontinued | $19.95 | $20.42 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $77.62 Typical High $134.90 | Professional | 54 · Surgery only | $75.86 | $77.62 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $26.92 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $72.44 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $70.79 | $72.44 | $125.89 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 37th of 51
$178
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.