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 $85.11 Median $1,548.82 Typical High $3,311.31 | Facility | None | $85.11 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $169.82 | Professional | None | $83.18 | $123.03 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $645.65 | Professional | None | $85.11 | $97.72 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $257.04 | Professional | None | $95.50 | $158.49 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $407.38 | Professional | None | $173.78 | $218.78 | $407.38 |
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 $70.79 Median $158.49 Typical High $371.54 | Professional | None | $70.79 | $158.49 | $371.54 |
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 $41.69 Median $42.66 Typical High $79.43 | Professional | 52 · Reduced service | $41.69 | $42.66 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.38 Typical High $31.62 | Professional | 53 · Discontinued | $16.60 | $17.38 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $64.57 Typical High $120.23 | Professional | 54 · Surgery only | $63.10 | $64.57 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.88 Typical High $23.99 | Professional | 55 · Aftercare only | $12.59 | $12.88 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $60.26 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $58.88 | $60.26 | $112.20 |
Where Washington, DC sits
The same service costs 4.5 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· 38th of 51
$138
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.