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 $87.10 Median $1,698.24 Typical High $4,073.80 | Facility | None | $87.10 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $158.49 | Professional | None | $87.10 | $120.23 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $645.65 | Professional | None | $89.13 | $97.72 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $239.88 | Professional | None | $85.11 | $134.90 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $331.13 | Professional | None | $147.91 | $169.82 | $331.13 |
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 $79.43 Median $131.83 Typical High $309.03 | Professional | None | $79.43 | $131.83 | $309.03 |
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 $42.66 Median $43.65 Typical High $72.44 | Professional | 52 · Reduced service | $42.66 | $43.65 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $29.51 | Professional | 53 · Discontinued | $16.98 | $17.38 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $109.65 | Professional | 54 · Surgery only | $64.57 | $64.57 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $21.88 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $60.26 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $60.26 | $60.26 | $102.33 |
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· 43rd of 51
$120
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.