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 $162.18 Median $1,698.24 Typical High $4,073.80 | Facility | None | $162.18 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $407.38 | Professional | None | $147.91 | $162.18 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $2,089.30 | Professional | None | $158.49 | $173.78 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $457.09 | Professional | None | $141.25 | $162.18 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $309.03 Typical High $371.54 | Professional | None | $158.49 | $309.03 | $371.54 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $457.09 | Professional | None | $114.82 | $213.80 | $457.09 |
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 $75.86 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $30.20 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.14 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $104.71 | $114.82 | $114.82 |
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· 39th of 51
$174
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.