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 $245.47 Median $1,548.82 Typical High $3,311.31 | Facility | None | $245.47 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $630.96 | Professional | None | $213.80 | $251.19 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $741.31 | Professional | None | $181.97 | $269.15 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $691.83 | Professional | None | $208.93 | $245.47 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $549.54 Typical High $575.44 | Professional | None | $281.84 | $549.54 | $575.44 |
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 $165.96 Median $309.03 Typical High $676.08 | Professional | None | $165.96 | $309.03 | $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 $104.71 Median $123.03 Typical High $125.89 | Professional | 52 · Reduced service | $104.71 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $48.98 Typical High $50.12 | Professional | 53 · Discontinued | $41.69 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $186.21 | Professional | 54 · Surgery only | $158.49 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $37.15 Typical High $38.02 | Professional | 55 · Aftercare only | $31.62 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $24.55 Typical High $25.12 | Professional | 56 · Pre-op care only | $20.89 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $169.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $147.91 | $169.82 | $173.78 |
Where Washington, DC sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 32nd of 51
$269
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.