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 $194.98 Median $2,818.38 Typical High $4,786.30 | Facility | None | $194.98 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $389.05 | Professional | None | $186.21 | $275.42 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $199.53 | Professional | None | $158.49 | $173.78 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $436.52 | Professional | None | $165.96 | $263.03 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $562.34 | Professional | None | $302.00 | $331.13 | $562.34 |
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 $134.90 Median $229.09 Typical High $478.63 | Professional | None | $134.90 | $229.09 | $478.63 |
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 $93.33 Median $114.82 Typical High $194.98 | Professional | 52 · Reduced service | $93.33 | $114.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $45.71 Typical High $77.62 | Professional | 53 · Discontinued | $37.15 | $45.71 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $169.82 Typical High $288.40 | Professional | 54 · Surgery only | $138.04 | $169.82 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.88 Typical High $57.54 | Professional | 55 · Aftercare only | $27.54 | $33.88 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $38.90 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $158.49 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $128.82 | $158.49 | $269.15 |
Where Washington, DC sits
The same service costs 3.4 times more in Wyoming 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
$195
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.