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 $281.84 Median $1,548.82 Typical High $3,311.31 | Facility | None | $281.84 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $407.38 | Professional | None | $275.42 | $302.00 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $645.65 | Professional | None | $281.84 | $316.23 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $758.58 | Professional | None | $269.15 | $338.84 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $812.83 | Professional | None | $363.08 | $416.87 | $812.83 |
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 $245.47 Median $354.81 Typical High $758.58 | Professional | None | $245.47 | $354.81 | $758.58 |
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 $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $70.79 | Professional | 53 · Discontinued | $54.95 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $208.93 Typical High $269.15 | Professional | 54 · Surgery only | $204.17 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $41.69 Typical High $53.70 | Professional | 55 · Aftercare only | $40.74 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $35.48 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $194.98 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $190.55 | $194.98 | $251.19 |
Where Washington, DC sits
The same service costs 4.7 times more in Alaska than in Texas. 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· 35th of 51
$339
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.