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 $302.00 Median $2,818.38 Typical High $4,786.30 | Facility | None | $302.00 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $302.00 Typical High $398.11 | Professional | None | $295.12 | $302.00 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | None | $245.47 | $269.15 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $524.81 | Professional | None | $257.04 | $331.13 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $660.69 | Professional | None | $316.23 | $354.81 | $660.69 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $676.08 | Professional | None | $213.80 | $302.00 | $676.08 |
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 $147.91 Median $151.36 Typical High $199.53 | Professional | 52 · Reduced service | $147.91 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $60.26 Typical High $79.43 | Professional | 53 · Discontinued | $58.88 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $229.09 Typical High $295.12 | Professional | 54 · Surgery only | $218.78 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $45.71 Typical High $60.26 | Professional | 55 · Aftercare only | $43.65 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $29.51 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $213.80 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $204.17 | $213.80 | $275.42 |
Where Washington, DC sits
The same service costs 4.3 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· 43rd of 51
$302
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.