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 $123.03 Median $1,698.24 Typical High $4,073.80 | Facility | None | $123.03 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $309.03 | Professional | None | $120.23 | $194.98 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $645.65 | Professional | None | $123.03 | $138.04 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $331.13 | Professional | None | $117.49 | $186.21 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $457.09 | Professional | None | $199.53 | $229.09 | $457.09 |
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 $112.20 Median $181.97 Typical High $416.87 | Professional | None | $112.20 | $181.97 | $416.87 |
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 $60.26 Median $61.66 Typical High $100.00 | Professional | 52 · Reduced service | $60.26 | $61.66 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $39.81 | Professional | 53 · Discontinued | $23.99 | $24.55 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $151.36 | Professional | 54 · Surgery only | $91.20 | $91.20 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $30.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $141.25 |
Where Washington, DC sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 38th of 51
$178
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.