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 $134.90 Median $1,548.82 Typical High $3,311.31 | Facility | None | $134.90 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $234.42 | Professional | None | $134.90 | $144.54 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $645.65 | Professional | None | $91.20 | $117.49 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $512.86 | Professional | None | $120.23 | $199.53 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $436.52 | Professional | None | $204.17 | $218.78 | $436.52 |
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 $100.00 Median $234.42 Typical High $512.86 | Professional | None | $100.00 | $234.42 | $512.86 |
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 $60.26 Median $67.61 Typical High $117.49 | Professional | 52 · Reduced service | $60.26 | $67.61 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $26.92 Typical High $46.77 | Professional | 53 · Discontinued | $23.99 | $26.92 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $102.33 Typical High $173.78 | Professional | 54 · Surgery only | $91.20 | $102.33 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.42 Typical High $34.67 | Professional | 55 · Aftercare only | $18.20 | $20.42 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.49 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.02 | $13.49 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $95.50 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $85.11 | $95.50 | $162.18 |
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· 22nd of 51
$204
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.