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 $97.72 Median $1,698.24 Typical High $4,073.80 | Facility | None | $97.72 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $131.83 | Professional | None | $93.33 | $109.65 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $645.65 | Professional | None | $100.00 | $112.20 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $363.08 | Professional | None | $83.18 | $128.82 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $309.03 | Professional | None | $162.18 | $229.09 | $309.03 |
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 $77.62 Median $147.91 Typical High $331.13 | Professional | None | $77.62 | $147.91 | $331.13 |
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 $47.86 Median $53.70 Typical High $66.07 | Professional | 52 · Reduced service | $47.86 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $21.38 Typical High $26.92 | Professional | 53 · Discontinued | $19.05 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $81.28 Typical High $100.00 | Professional | 54 · Surgery only | $72.44 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.22 Typical High $19.95 | Professional | 55 · Aftercare only | $14.45 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.72 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.55 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $75.86 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $67.61 | $75.86 | $93.33 |
Where Washington, DC sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 36th of 51
$123
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.