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 $275.42 Median $1,698.24 Typical High $5,248.07 | Facility | None | $275.42 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $741.31 | Professional | None | $275.42 | $426.58 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $1,584.89 | Professional | None | $257.04 | $288.40 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $741.31 | Professional | None | $288.40 | $426.58 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,023.29 | Professional | None | $446.68 | $645.65 | $1,023.29 |
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 $257.04 Median $407.38 Typical High $912.01 | Professional | None | $257.04 | $407.38 | $912.01 |
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 $138.04 Median $138.04 Typical High $218.78 | Professional | 52 · Reduced service | $138.04 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $89.13 | Professional | 53 · Discontinued | $54.95 | $56.23 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $208.93 Typical High $331.13 | Professional | 54 · Surgery only | $204.17 | $208.93 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $66.07 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $43.65 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $194.98 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $190.55 | $194.98 | $309.03 |
Where Washington, DC sits
The same service costs 3.4 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· 32nd 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.