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 $354.81 Median $933.25 Typical High $3,311.31 | Facility | None | $354.81 | $933.25 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $354.81 Typical High $851.14 | Professional | None | $186.21 | $354.81 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $2,089.30 | Professional | None | $181.97 | $199.53 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $933.25 | Professional | None | $173.78 | $338.84 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $794.33 | Professional | None | $363.08 | $426.58 | $794.33 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $173.78 Median $363.08 Typical High $851.14 | Professional | None | $173.78 | $363.08 | $851.14 |
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 $93.33 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $38.02 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $141.25 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $28.18 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.62 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $213.80 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $131.83 | $213.80 | $245.47 |
Where Washington, DC sits
The same service costs 3.8 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· 23rd of 51
$347
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.