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 $120.23 Median $309.03 Typical High $3,311.31 | Facility | None | $120.23 | $309.03 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $204.17 | Professional | None | $69.18 | $114.82 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $645.65 | Professional | None | $70.79 | $79.43 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $190.55 | Professional | None | $67.61 | $109.65 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $269.15 | Professional | None | $117.49 | $138.04 | $269.15 |
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 $63.10 Median $109.65 Typical High $245.47 | Professional | None | $63.10 | $109.65 | $245.47 |
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 $33.11 Median $34.67 Typical High $60.26 | Professional | 52 · Reduced service | $33.11 | $34.67 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.80 Typical High $23.99 | Professional | 53 · Discontinued | $13.49 | $13.80 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $51.29 Typical High $89.13 | Professional | 54 · Surgery only | $50.12 | $51.29 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.47 Typical High $18.20 | Professional | 55 · Aftercare only | $10.00 | $10.47 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.92 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.76 | $6.92 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $47.86 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $46.77 | $47.86 | $83.18 |
Where Washington, DC sits
The same service costs 3.9 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· 28th of 51
$110
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.