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 $331.13 Median $1,698.24 Typical High $4,073.80 | Facility | None | $331.13 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $851.14 | Professional | None | $288.40 | $354.81 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $741.31 | Professional | None | $288.40 | $354.81 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $977.24 | Professional | None | $281.84 | $346.74 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $758.58 Typical High $812.83 | Professional | None | $398.11 | $758.58 | $812.83 |
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 $239.88 Median $436.52 Typical High $912.01 | Professional | None | $239.88 | $436.52 | $912.01 |
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 $154.88 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $154.88 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $61.66 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $53.70 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $229.09 | $251.19 |
Where Washington, DC sits
The same service costs 5.8 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
$355
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.