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 $263.03 Median $1,698.24 Typical High $4,073.80 | Facility | None | $263.03 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $426.58 | Professional | None | $251.19 | $275.42 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $257.04 | Professional | None | $199.53 | $223.87 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $512.86 | Professional | None | $229.09 | $323.59 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $660.69 | Professional | None | $371.54 | $407.38 | $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 $181.97 Median $288.40 Typical High $645.65 | Professional | None | $181.97 | $288.40 | $645.65 |
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 $125.89 Median $138.04 Typical High $213.80 | Professional | 52 · Reduced service | $125.89 | $138.04 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $85.11 | Professional | 53 · Discontinued | $50.12 | $54.95 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $323.59 | Professional | 54 · Surgery only | $190.55 | $208.93 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $64.57 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $42.66 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $302.00 |
Where Washington, DC sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 47th of 51
$263
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.