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 $213.80 Median $1,698.24 Typical High $4,073.80 | Facility | None | $213.80 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $257.04 | Professional | None | $199.53 | $213.80 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $549.54 | Professional | None | $218.78 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $707.95 | Professional | None | $134.90 | $251.19 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $588.84 | Professional | None | $288.40 | $489.78 | $588.84 |
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 $125.89 Median $281.84 Typical High $645.65 | Professional | None | $125.89 | $281.84 | $645.65 |
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 $100.00 Median $107.15 Typical High $128.82 | Professional | 52 · Reduced service | $100.00 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $51.29 | Professional | 53 · Discontinued | $39.81 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $162.18 Typical High $194.98 | Professional | 54 · Surgery only | $151.36 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $38.90 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $151.36 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $141.25 | $151.36 | $181.97 |
Where Washington, DC sits
The same service costs 5.0 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· 30th 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.