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 $173.78 Median $616.60 Typical High $4,073.80 | Facility | None | $173.78 | $616.60 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $275.42 | Professional | None | $173.78 | $218.78 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $645.65 | Professional | None | $141.25 | $162.18 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $616.60 | Professional | None | $158.49 | $239.88 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $575.44 | Professional | None | $251.19 | $263.03 | $575.44 |
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 $162.18 Median $354.81 Typical High $630.96 | Professional | None | $162.18 | $354.81 | $630.96 |
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 $87.10 Median $97.72 Typical High $138.04 | Professional | 52 · Reduced service | $87.10 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.90 Typical High $54.95 | Professional | 53 · Discontinued | $34.67 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $144.54 Typical High $208.93 | Professional | 54 · Surgery only | $128.82 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.84 Typical High $41.69 | Professional | 55 · Aftercare only | $25.70 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.50 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $134.90 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $120.23 | $134.90 | $194.98 |
Where Washington, DC sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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
$275
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.