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 $302.00 Median $2,818.38 Typical High $4,786.30 | Facility | None | $302.00 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $537.03 | Professional | None | $302.00 | $302.00 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $1,584.89 | Professional | None | $239.88 | $263.03 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $812.83 | Professional | None | $309.03 | $478.63 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,202.26 | Professional | None | $575.44 | $707.95 | $1,202.26 |
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 $275.42 Median $457.09 Typical High $1,047.13 | Professional | None | $275.42 | $457.09 | $1,047.13 |
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 $151.36 Median $151.36 Typical High $269.15 | Professional | 52 · Reduced service | $151.36 | $151.36 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $107.15 | Professional | 53 · Discontinued | $60.26 | $60.26 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $229.09 Typical High $398.11 | Professional | 54 · Surgery only | $223.87 | $229.09 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $45.71 Typical High $79.43 | Professional | 55 · Aftercare only | $44.67 | $45.71 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $53.70 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $213.80 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $208.93 | $213.80 | $371.54 |
Where Washington, DC sits
The same service costs 3.9 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· 41st of 51
$407
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.