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 $154.88 Median $562.34 Typical High $4,073.80 | Facility | None | $154.88 | $562.34 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $602.56 | Professional | None | $154.88 | $269.15 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $645.65 | Professional | None | $107.15 | $144.54 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $575.44 | Professional | None | $131.83 | $223.87 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $501.19 | Professional | None | $234.42 | $245.47 | $501.19 |
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 $109.65 Median $251.19 Typical High $549.54 | Professional | None | $109.65 | $251.19 | $549.54 |
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 $69.18 Median $77.62 Typical High $131.83 | Professional | 52 · Reduced service | $69.18 | $77.62 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $30.90 Typical High $53.70 | Professional | 53 · Discontinued | $27.54 | $30.90 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $114.82 Typical High $199.53 | Professional | 54 · Surgery only | $102.33 | $114.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.91 Typical High $39.81 | Professional | 55 · Aftercare only | $20.42 | $22.91 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.49 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.80 | $15.49 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $107.15 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $95.50 | $107.15 | $186.21 |
Where Washington, DC sits
The same service costs 4.5 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· 18th of 51
$234
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.