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 $144.54 Median $1,698.24 Typical High $4,073.80 | Facility | None | $144.54 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $295.12 | Professional | None | $138.04 | $234.42 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $144.54 | Professional | None | $112.20 | $125.89 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $323.59 | Professional | None | $120.23 | $208.93 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $467.74 | Professional | None | $229.09 | $251.19 | $467.74 |
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 $102.33 Median $194.98 Typical High $346.74 | Professional | None | $102.33 | $194.98 | $346.74 |
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 $69.18 Median $97.72 Typical High $147.91 | Professional | 52 · Reduced service | $69.18 | $97.72 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $39.81 Typical High $58.88 | Professional | 53 · Discontinued | $27.54 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $147.91 Typical High $223.87 | Professional | 54 · Surgery only | $104.71 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $44.67 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $29.51 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $138.04 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $97.72 | $138.04 | $208.93 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska 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· 50th of 51
$145
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.