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 $234.42 Median $2,818.38 Typical High $4,786.30 | Facility | None | $234.42 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $354.81 | Professional | None | $234.42 | $263.03 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $2,089.30 | Professional | None | $190.55 | $213.80 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $812.83 | Professional | None | $213.80 | $316.23 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $676.08 | Professional | None | $331.13 | $346.74 | $676.08 |
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 $199.53 Median $398.11 Typical High $812.83 | Professional | None | $199.53 | $398.11 | $812.83 |
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 $117.49 Median $131.83 Typical High $173.78 | Professional | 52 · Reduced service | $117.49 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $52.48 Typical High $70.79 | Professional | 53 · Discontinued | $46.77 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $173.78 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $34.67 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.44 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $162.18 | $186.21 | $245.47 |
Where Washington, DC sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 33rd of 51
$324
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.