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 $173.78 Median $2,818.38 Typical High $4,786.30 | Facility | None | $173.78 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $173.78 Typical High $275.42 | Professional | None | $169.82 | $173.78 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $2,570.40 | Professional | None | $186.21 | $208.93 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $512.86 | Professional | None | $190.55 | $295.12 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $691.83 | Professional | None | $309.03 | $436.52 | $691.83 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $616.60 | Professional | None | $173.78 | $275.42 | $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 $85.11 Median $87.10 Typical High $138.04 | Professional | 52 · Reduced service | $85.11 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $54.95 | Professional | 53 · Discontinued | $33.88 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $128.82 Typical High $204.17 | Professional | 54 · Surgery only | $125.89 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $40.74 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.98 | $17.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $120.23 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $117.49 | $120.23 | $190.55 |
Where Washington, DC sits
The same service costs 3.5 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· 39th of 51
$263
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.