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 $154.88 Median $1,548.82 Typical High $3,311.31 | Facility | None | $154.88 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $281.84 | Professional | None | $147.91 | $194.98 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $165.96 | Professional | None | $128.82 | $144.54 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $331.13 | Professional | None | $131.83 | $208.93 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $457.09 | Professional | None | $223.87 | $245.47 | $457.09 |
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 $107.15 Median $181.97 Typical High $380.19 | Professional | None | $107.15 | $181.97 | $380.19 |
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 $74.13 Median $95.50 Typical High $141.25 | Professional | 52 · Reduced service | $74.13 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.02 Typical High $56.23 | Professional | 53 · Discontinued | $29.51 | $38.02 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $144.54 Typical High $213.80 | Professional | 54 · Surgery only | $112.20 | $144.54 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $42.66 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.05 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.79 | $19.05 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $134.90 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $104.71 | $134.90 | $199.53 |
Where Washington, DC sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 51st of 51
$158
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.