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 $107.15 Median $1,698.24 Typical High $4,073.80 | Facility | None | $107.15 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $281.84 | Professional | None | $107.15 | $123.03 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $645.65 | Professional | None | $114.82 | $125.89 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $338.84 | Professional | None | $97.72 | $123.03 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $288.40 | Professional | None | $134.90 | $251.19 | $288.40 |
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 $87.10 Median $151.36 Typical High $316.23 | Professional | None | $87.10 | $151.36 | $316.23 |
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 $52.48 Median $56.23 Typical High $61.66 | Professional | 52 · Reduced service | $52.48 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $25.12 | Professional | 53 · Discontinued | $20.89 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $77.62 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.47 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $77.62 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $72.44 | $77.62 | $87.10 |
Where Washington, DC sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 35th of 51
$126
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.