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 $218.78 Median $1,548.82 Typical High $3,311.31 | Facility | None | $218.78 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $575.44 | Professional | None | $208.93 | $234.42 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $645.65 | Professional | None | $218.78 | $251.19 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $645.65 | Professional | None | $181.97 | $229.09 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $512.86 Typical High $537.03 | Professional | None | $257.04 | $512.86 | $537.03 |
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 $162.18 Median $295.12 Typical High $616.60 | Professional | None | $162.18 | $295.12 | $616.60 |
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 $102.33 Median $109.65 Typical High $117.49 | Professional | 52 · Reduced service | $102.33 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $46.77 | Professional | 53 · Discontinued | $41.69 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $165.96 Typical High $177.83 | Professional | 54 · Surgery only | $154.88 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.11 Typical High $35.48 | Professional | 55 · Aftercare only | $30.90 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $154.88 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $144.54 | $154.88 | $165.96 |
Where Washington, DC sits
The same service costs 5.1 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· 32nd of 51
$251
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.