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 $147.91 Median $1,698.24 Typical High $4,073.80 | Facility | None | $147.91 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $346.74 | Professional | None | $134.90 | $147.91 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $2,089.30 | Professional | None | $104.71 | $138.04 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $741.31 | Professional | None | $131.83 | $288.40 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $645.65 | Professional | None | $295.12 | $309.03 | $645.65 |
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 $112.20 Median $309.03 Typical High $741.31 | Professional | None | $112.20 | $309.03 | $741.31 |
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 $67.61 Median $74.13 Typical High $169.82 | Professional | 52 · Reduced service | $67.61 | $74.13 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.20 Typical High $69.18 | Professional | 53 · Discontinued | $26.92 | $30.20 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $112.20 Typical High $257.04 | Professional | 54 · Surgery only | $100.00 | $112.20 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $22.39 Typical High $51.29 | Professional | 55 · Aftercare only | $19.95 | $22.39 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.79 Typical High $34.67 | Professional | 56 · Pre-op care only | $13.49 | $14.79 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $104.71 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $93.33 | $104.71 | $239.88 |
Where Washington, DC sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 21st of 51
$263
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.