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 $190.55 Median $2,818.38 Typical High $4,786.30 | Facility | None | $190.55 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $309.03 | Professional | None | $190.55 | $239.88 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $194.98 | Professional | None | $151.36 | $169.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $389.05 | Professional | None | $169.82 | $251.19 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $575.44 | Professional | None | $251.19 | $281.84 | $575.44 |
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 $147.91 Median $239.88 Typical High $467.74 | Professional | None | $147.91 | $239.88 | $467.74 |
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 $95.50 Median $117.49 Typical High $154.88 | Professional | 52 · Reduced service | $95.50 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $46.77 Typical High $61.66 | Professional | 53 · Discontinued | $38.90 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $234.42 | Professional | 54 · Surgery only | $144.54 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $28.84 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $165.96 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $134.90 | $165.96 | $218.78 |
Where Washington, DC sits
The same service costs 3.6 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· 47th of 51
$200
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.