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 $1,548.82 Typical High $3,311.31 | Facility | None | $131.83 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $177.83 | Professional | None | $125.89 | $144.54 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $144.54 | Professional | None | $109.65 | $123.03 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $239.88 | Professional | None | $112.20 | $151.36 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $309.03 | Professional | None | $144.54 | $162.18 | $309.03 |
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 $95.50 Median $134.90 Typical High $309.03 | Professional | None | $95.50 | $134.90 | $309.03 |
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 $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $63.10 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $25.12 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $134.90 | Professional | 54 · Surgery only | $93.33 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $93.33 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $87.10 | $93.33 | $125.89 |
Where Washington, DC sits
The same service costs 4.0 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· 43rd 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.