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 $269.15 Median $2,818.38 Typical High $4,786.30 | Facility | None | $269.15 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $363.08 | Professional | None | $263.03 | $281.84 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $645.65 | Professional | None | $269.15 | $302.00 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $724.44 | Professional | None | $257.04 | $346.74 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $812.83 | Professional | None | $371.54 | $426.58 | $812.83 |
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 $239.88 Median $363.08 Typical High $776.25 | Professional | None | $239.88 | $363.08 | $776.25 |
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 $131.83 Median $134.90 Typical High $181.97 | Professional | 52 · Reduced service | $131.83 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $72.44 | Professional | 53 · Discontinued | $52.48 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | 54 · Surgery only | $199.53 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.92 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.30 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $251.19 |
Where Washington, DC sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 34th of 51
$339
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.