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 $199.53 Median $1,548.82 Typical High $3,311.31 | Facility | None | $199.53 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $794.33 | Professional | None | $199.53 | $316.23 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $645.65 | Professional | None | $158.49 | $177.83 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $537.03 | Professional | None | $204.17 | $302.00 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $758.58 | Professional | None | $331.13 | $467.74 | $758.58 |
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 $181.97 Median $295.12 Typical High $645.65 | Professional | None | $181.97 | $295.12 | $645.65 |
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 $100.00 Median $100.00 Typical High $165.96 | Professional | 52 · Reduced service | $100.00 | $100.00 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $66.07 | Professional | 53 · Discontinued | $39.81 | $39.81 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $151.36 Typical High $245.47 | Professional | 54 · Surgery only | $147.91 | $151.36 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.20 Typical High $50.12 | Professional | 55 · Aftercare only | $29.51 | $30.20 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $141.25 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $138.04 | $141.25 | $229.09 |
Where Washington, DC sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 28th of 51
$295
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.