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 $363.08 Median $1,047.13 Typical High $3,311.31 | Facility | None | $363.08 | $1,047.13 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $380.19 Typical High $933.25 | Professional | None | $151.36 | $380.19 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $2,089.30 | Professional | None | $144.54 | $162.18 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $354.81 Typical High $1,023.29 | Professional | None | $141.25 | $354.81 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $870.96 | Professional | None | $346.74 | $426.58 | $870.96 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $131.83 Median $363.08 Typical High $933.25 | Professional | None | $131.83 | $363.08 | $933.25 |
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 $75.86 Median $165.96 Typical High $194.98 | Professional | 52 · Reduced service | $75.86 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $66.07 Typical High $77.62 | Professional | 53 · Discontinued | $30.20 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $245.47 Typical High $295.12 | Professional | 54 · Surgery only | $114.82 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $22.91 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $33.11 Typical High $38.90 | Professional | 56 · Pre-op care only | $15.14 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $229.09 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $107.15 | $229.09 | $275.42 |
Where Washington, DC sits
The same service costs 4.0 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· 21st of 51
$363
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.