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 $147.91 Median $1,548.82 Typical High $3,311.31 | Facility | None | $147.91 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $269.15 | Professional | None | $141.25 | $213.80 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $151.36 | Professional | None | $117.49 | $131.83 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $309.03 | Professional | None | $125.89 | $199.53 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $416.87 | Professional | None | $208.93 | $234.42 | $416.87 |
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 $102.33 Median $177.83 Typical High $363.08 | Professional | None | $102.33 | $177.83 | $363.08 |
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 $70.79 Median $89.13 Typical High $134.90 | Professional | 52 · Reduced service | $70.79 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $35.48 Typical High $53.70 | Professional | 53 · Discontinued | $28.18 | $35.48 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $134.90 Typical High $199.53 | Professional | 54 · Surgery only | $104.71 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.92 Typical High $39.81 | Professional | 55 · Aftercare only | $20.89 | $26.92 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $17.78 Typical High $26.92 | Professional | 56 · Pre-op care only | $14.13 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $125.89 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $97.72 | $125.89 | $186.21 |
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· 50th of 51
$148
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.