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 $281.84 Median $1,412.54 Typical High $7,943.28 | Facility | None | $281.84 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $776.25 | Professional | None | $257.04 | $316.23 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $645.65 | Professional | None | $218.78 | $309.03 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $851.14 | Professional | None | $234.42 | $309.03 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $724.44 | Professional | None | $389.05 | $660.69 | $724.44 |
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 $199.53 Median $380.19 Typical High $794.33 | Professional | None | $199.53 | $380.19 | $794.33 |
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 $128.82 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $128.82 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $51.29 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $234.42 | Professional | 54 · Surgery only | $194.98 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $218.78 |
Where Washington, DC sits
The same service costs 5.1 times more in Alaska than in Texas. 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· 34th of 51
$309
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.