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 $70.79 Median $1,698.24 Typical High $4,073.80 | Facility | None | $70.79 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $107.15 | Professional | None | $69.18 | $81.28 | $107.15 |
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 $95.50 Typical High $190.55 | Professional | None | $67.61 | $95.50 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $234.42 | Professional | None | $102.33 | $117.49 | $234.42 |
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 $57.54 Median $91.20 Typical High $204.17 | Professional | None | $57.54 | $91.20 | $204.17 |
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 $34.67 Median $35.48 Typical High $52.48 | Professional | 52 · Reduced service | $34.67 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $20.89 | Professional | 53 · Discontinued | $14.13 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $53.70 Typical High $77.62 | Professional | 54 · Surgery only | $52.48 | $53.70 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $15.49 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $50.12 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $48.98 | $50.12 | $72.44 |
Where Washington, DC sits
The same service costs 3.8 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· 40th of 51
$91.20
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.