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 $257.04 Median $1,698.24 Typical High $4,073.80 | Facility | None | $257.04 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $660.69 | Professional | None | $223.87 | $263.03 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $741.31 | Professional | None | $199.53 | $288.40 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $724.44 | Professional | None | $218.78 | $257.04 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $575.44 Typical High $616.60 | Professional | None | $288.40 | $575.44 | $616.60 |
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 $177.83 Median $323.59 Typical High $724.44 | Professional | None | $177.83 | $323.59 | $724.44 |
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 $112.20 Median $128.82 Typical High $131.83 | Professional | 52 · Reduced service | $112.20 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $52.48 | Professional | 53 · Discontinued | $45.71 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $190.55 Typical High $199.53 | Professional | 54 · Surgery only | $169.82 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.90 Typical High $39.81 | Professional | 55 · Aftercare only | $33.88 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.70 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.39 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $177.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $158.49 | $177.83 | $186.21 |
Where Washington, DC sits
The same service costs 5.2 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· 33rd of 51
$275
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.