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 $190.55 Median $229.09 Typical High $281.84 | Professional | None | $190.55 | $229.09 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $218.78 | Professional | None | $158.49 | $173.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $363.08 | Professional | None | $169.82 | $234.42 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $467.74 | Professional | None | $223.87 | $251.19 | $467.74 |
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 $144.54 Median $208.93 Typical High $457.09 | Professional | None | $144.54 | $208.93 | $457.09 |
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 $95.50 Median $104.71 Typical High $141.25 | Professional | 52 · Reduced service | $95.50 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $41.69 Typical High $56.23 | Professional | 53 · Discontinued | $38.02 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $154.88 Typical High $213.80 | Professional | 54 · Surgery only | $141.25 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.90 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.05 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $144.54 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $131.83 | $144.54 | $199.53 |
Where Washington, DC sits
The same service costs 4.1 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· 49th 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.