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 $50.12 Median $1,412.54 Typical High $7,943.28 | Facility | None | $50.12 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $54.95 | Professional | None | $46.77 | $50.12 | $54.95 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $645.65 | Professional | None | $48.98 | $54.95 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $131.83 | Professional | None | $43.65 | $50.12 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $120.23 | Professional | None | $54.95 | $63.10 | $120.23 |
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 $37.15 Median $56.23 Typical High $131.83 | Professional | None | $37.15 | $56.23 | $131.83 |
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 $24.55 Median $24.55 Typical High $26.92 | Professional | 52 · Reduced service | $24.55 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $9.77 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $39.81 | Professional | 54 · Surgery only | $37.15 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.94 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.01 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.90 | $5.01 | $5.37 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | 78 · Unplanned return to OR | $34.67 | $34.67 | $37.15 |
Where Washington, DC sits
The same service costs 4.6 times more in Alaska than in New York. 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· 36th of 51
$53.70
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.