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 $162.18 Median $1,698.24 Typical High $4,073.80 | Facility | None | $162.18 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $407.38 | Professional | None | $158.49 | $263.03 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $2,089.30 | Professional | None | $134.90 | $169.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $758.58 | Professional | None | $151.36 | $269.15 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $645.65 | Professional | None | $295.12 | $371.54 | $645.65 |
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 $141.25 Median $295.12 Typical High $707.95 | Professional | None | $141.25 | $295.12 | $707.95 |
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 $81.28 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $81.28 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $32.36 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $120.23 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $35.48 Typical High $42.66 | Professional | 55 · Aftercare only | $23.99 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.22 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $112.20 | $165.96 | $199.53 |
Where Washington, DC sits
The same service costs 4.5 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· 29th of 51
$263
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.