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 $213.80 Median $1,698.24 Typical High $4,073.80 | Facility | None | $213.80 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $316.23 | Professional | None | $204.17 | $229.09 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $218.78 | Professional | None | $169.82 | $190.55 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $389.05 | Professional | None | $181.97 | $251.19 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $524.81 | Professional | None | $251.19 | $281.84 | $524.81 |
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 $147.91 Median $229.09 Typical High $512.86 | Professional | None | $147.91 | $229.09 | $512.86 |
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 $102.33 Median $114.82 Typical High $158.49 | Professional | 52 · Reduced service | $102.33 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $64.57 | Professional | 53 · Discontinued | $40.74 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $169.82 Typical High $239.88 | Professional | 54 · Surgery only | $154.88 | $169.82 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $47.86 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $158.49 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $144.54 | $158.49 | $223.87 |
Where Washington, DC sits
The same service costs 4.2 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· 42nd of 51
$214
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.