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 $56.23 Median $1,548.82 Typical High $3,311.31 | Facility | None | $56.23 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $141.25 | Professional | None | $56.23 | $69.18 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $645.65 | Professional | None | $56.23 | $63.10 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $151.36 | Professional | None | $53.70 | $66.07 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $131.83 Typical High $162.18 | Professional | None | $70.79 | $131.83 | $162.18 |
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 $44.67 Median $69.18 Typical High $165.96 | Professional | None | $44.67 | $69.18 | $165.96 |
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 $27.54 Median $28.18 Typical High $34.67 | Professional | 52 · Reduced service | $27.54 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $14.13 | Professional | 53 · Discontinued | $10.96 | $11.22 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $41.69 Typical High $52.48 | Professional | 54 · Surgery only | $40.74 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.51 Typical High $10.47 | Professional | 55 · Aftercare only | $8.13 | $8.51 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $6.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $38.90 Typical High $48.98 | Professional | 78 · Unplanned return to OR | $38.02 | $38.90 | $48.98 |
Where Washington, DC sits
The same service costs 4.2 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· 36th of 51
$67.61
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.