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 $190.55 Median $1,698.24 Typical High $4,073.80 | Facility | None | $190.55 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $478.63 | Professional | None | $186.21 | $302.00 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $1,380.38 | Professional | None | $151.36 | $165.96 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $512.86 | Professional | None | $194.98 | $288.40 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $724.44 | Professional | None | $338.84 | $446.68 | $724.44 |
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 $173.78 Median $275.42 Typical High $630.96 | Professional | None | $173.78 | $275.42 | $630.96 |
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 $93.33 Median $95.50 Typical High $158.49 | Professional | 52 · Reduced service | $93.33 | $95.50 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $63.10 | Professional | 53 · Discontinued | $38.02 | $38.02 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $144.54 Typical High $234.42 | Professional | 54 · Surgery only | $141.25 | $144.54 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.84 Typical High $46.77 | Professional | 55 · Aftercare only | $28.18 | $28.84 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.05 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.62 | $19.05 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $134.90 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $131.83 | $134.90 | $218.78 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Hawaii. 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
$275
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.