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 $186.21 Median $1,698.24 Typical High $4,786.30 | Facility | None | $186.21 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $416.87 | Professional | None | $165.96 | $186.21 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $2,089.30 | Professional | None | $123.03 | $162.18 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $338.84 Typical High $870.96 | Professional | None | $162.18 | $338.84 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $776.25 | Professional | None | $346.74 | $363.08 | $776.25 |
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 $134.90 Median $363.08 Typical High $870.96 | Professional | None | $134.90 | $363.08 | $870.96 |
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 $83.18 Median $93.33 Typical High $204.17 | Professional | 52 · Reduced service | $83.18 | $93.33 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $37.15 Typical High $83.18 | Professional | 53 · Discontinued | $33.11 | $37.15 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $141.25 Typical High $309.03 | Professional | 54 · Surgery only | $125.89 | $141.25 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $61.66 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $131.83 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $117.49 | $131.83 | $288.40 |
Where Washington, DC sits
The same service costs 4.8 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
$316
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.