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 $83.18 Median $1,698.24 Typical High $4,073.80 | Facility | None | $83.18 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $316.23 | Professional | None | $81.28 | $125.89 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $741.31 | Professional | None | $75.86 | $85.11 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $346.74 | Professional | None | $70.79 | $120.23 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $288.40 | Professional | None | $134.90 | $190.55 | $288.40 |
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 $72.44 Median $131.83 Typical High $309.03 | Professional | None | $72.44 | $131.83 | $309.03 |
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 $40.74 Median $48.98 Typical High $63.10 | Professional | 52 · Reduced service | $40.74 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.95 Typical High $25.70 | Professional | 53 · Discontinued | $16.22 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $74.13 Typical High $95.50 | Professional | 54 · Surgery only | $61.66 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $14.79 Typical High $19.05 | Professional | 55 · Aftercare only | $12.30 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.77 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.13 | $9.77 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $69.18 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $57.54 | $69.18 | $89.13 |
Where Washington, DC sits
The same service costs 3.7 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
$120
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.