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 $107.15 Median $1,698.24 Typical High $4,073.80 | Facility | None | $107.15 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $181.97 | Professional | None | $104.71 | $138.04 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $645.65 | Professional | None | $107.15 | $117.49 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $288.40 | Professional | None | $100.00 | $158.49 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $389.05 | Professional | None | $169.82 | $199.53 | $389.05 |
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 $95.50 Median $154.88 Typical High $354.81 | Professional | None | $95.50 | $154.88 | $354.81 |
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 $52.48 Median $52.48 Typical High $87.10 | Professional | 52 · Reduced service | $52.48 | $52.48 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $34.67 | Professional | 53 · Discontinued | $20.89 | $21.38 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $79.43 Typical High $131.83 | Professional | 54 · Surgery only | $77.62 | $79.43 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.85 Typical High $26.30 | Professional | 55 · Aftercare only | $15.49 | $15.85 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $74.13 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $72.44 | $74.13 | $123.03 |
Where Washington, DC sits
The same service costs 3.5 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· 44th of 51
$141
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.