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 $309.03 Median $1,698.24 Typical High $4,073.80 | Facility | None | $309.03 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $354.81 | Professional | None | $269.15 | $309.03 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $741.31 | Professional | None | $245.47 | $331.13 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $933.25 | Professional | None | $263.03 | $331.13 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $707.95 Typical High $776.25 | Professional | None | $380.19 | $707.95 | $776.25 |
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 $223.87 Median $416.87 Typical High $870.96 | Professional | None | $223.87 | $416.87 | $870.96 |
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 $144.54 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $61.66 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $257.04 | Professional | 54 · Surgery only | $218.78 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $51.29 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $204.17 | $218.78 | $239.88 |
Where Washington, DC sits
The same service costs 5.5 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· 34th of 51
$331
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.