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 $1,548.82 Typical High $3,311.31 | Facility | None | $234.42 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $323.59 | Professional | None | $234.42 | $288.40 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $2,570.40 | Professional | None | $190.55 | $213.80 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $758.58 | Professional | None | $213.80 | $331.13 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $660.69 | Professional | None | $302.00 | $316.23 | $660.69 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $758.58 | Professional | None | $204.17 | $371.54 | $758.58 |
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 $138.04 Typical High $162.18 | Professional | 52 · Reduced service | $117.49 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $54.95 Typical High $64.57 | Professional | 53 · Discontinued | $46.77 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $208.93 Typical High $245.47 | Professional | 54 · Surgery only | $177.83 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $41.69 Typical High $48.98 | Professional | 55 · Aftercare only | $35.48 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $27.54 Typical High $32.36 | Professional | 56 · Pre-op care only | $23.44 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $194.98 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $165.96 | $194.98 | $229.09 |
Where Washington, DC sits
The same service costs 4.3 times more in Alaska 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· 35th 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.