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 $162.18 Median $229.09 Typical High $275.42 | Professional | None | $162.18 | $229.09 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $1,584.89 | Professional | None | $125.89 | $169.82 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $741.31 | Professional | None | $154.88 | $257.04 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $616.60 | Professional | None | $288.40 | $371.54 | $616.60 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $676.08 | Professional | None | $144.54 | $295.12 | $676.08 |
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 $79.43 Median $114.82 Typical High $138.04 | Professional | 52 · Reduced service | $79.43 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $32.36 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $120.23 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $23.99 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.22 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $162.18 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $112.20 | $162.18 | $194.98 |
Where Washington, DC sits
The same service costs 4.4 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· 31st of 51
$251
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.