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 $128.82 Median $1,698.24 Typical High $4,073.80 | Facility | None | $128.82 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $213.80 | Professional | None | $125.89 | $144.54 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $138.04 | Professional | None | $107.15 | $120.23 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $251.19 | Professional | None | $109.65 | $162.18 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $371.54 | Professional | None | $177.83 | $199.53 | $371.54 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $309.03 | Professional | None | $89.13 | $147.91 | $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 $72.44 Typical High $107.15 | Professional | 52 · Reduced service | $63.10 | $72.44 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.84 Typical High $43.65 | Professional | 53 · Discontinued | $25.12 | $28.84 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $107.15 Typical High $162.18 | Professional | 54 · Surgery only | $93.33 | $107.15 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.38 Typical High $32.36 | Professional | 55 · Aftercare only | $18.62 | $21.38 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.45 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.59 | $14.45 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $100.00 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $87.10 | $100.00 | $151.36 |
Where Washington, DC sits
The same service costs 3.5 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· 48th of 51
$129
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.