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 $131.83 Median $2,818.38 Typical High $4,786.30 | Facility | None | $131.83 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $229.09 | Professional | None | $125.89 | $154.88 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $141.25 | Professional | None | $109.65 | $123.03 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $275.42 | Professional | None | $112.20 | $173.78 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $363.08 | Professional | None | $186.21 | $204.17 | $363.08 |
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 $91.20 Median $147.91 Typical High $323.59 | Professional | None | $91.20 | $147.91 | $323.59 |
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 $63.10 Median $75.86 Typical High $114.82 | Professional | 52 · Reduced service | $63.10 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $25.12 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $114.82 Typical High $173.78 | Professional | 54 · Surgery only | $93.33 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $107.15 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $87.10 | $107.15 | $162.18 |
Where Washington, DC sits
The same service costs 3.4 times more in Alaska than in Florida. 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
$132
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.