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 $134.90 Median $2,818.38 Typical High $4,786.30 | Facility | None | $134.90 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $346.74 | Professional | None | $134.90 | $251.19 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $1,380.38 | Professional | None | $134.90 | $147.91 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $691.83 | Professional | None | $125.89 | $239.88 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $575.44 | Professional | None | $257.04 | $316.23 | $575.44 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $120.23 Median $263.03 Typical High $630.96 | Professional | None | $120.23 | $263.03 | $630.96 |
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 $67.61 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $67.61 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $26.92 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $102.33 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $20.42 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.49 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $154.88 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $95.50 | $154.88 | $177.83 |
Where Washington, DC sits
The same service costs 3.6 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· 24th of 51
$245
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.