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 $128.82 Median $1,698.24 Typical High $4,073.80 | Facility | None | $128.82 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $154.88 | Professional | None | $128.82 | $147.91 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $2,089.30 | Professional | None | $125.89 | $138.04 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $426.58 | Professional | None | $123.03 | $151.36 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $363.08 | Professional | None | $165.96 | $302.00 | $363.08 |
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 $117.49 Median $199.53 Typical High $398.11 | Professional | None | $117.49 | $199.53 | $398.11 |
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 $64.57 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $64.57 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $25.70 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $109.65 Typical High $117.49 | Professional | 54 · Surgery only | $95.50 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $23.44 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.88 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $102.33 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $89.13 | $102.33 | $109.65 |
Where Washington, DC sits
The same service costs 3.8 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
$155
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.