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 $2,137.96 Typical High $7,079.46 | Facility | None | $302.00 | $2,137.96 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | None | $263.03 | $302.00 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $338.84 | Professional | None | $245.47 | $269.15 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $478.63 | Professional | None | $245.47 | $275.42 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $512.86 | Professional | None | $218.78 | $245.47 | $512.86 |
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 $199.53 Median $239.88 Typical High $660.69 | Professional | None | $199.53 | $239.88 | $660.69 |
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 $141.25 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $141.25 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $56.23 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $213.80 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $199.53 | $213.80 | $213.80 |
Where Washington, DC sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 38th of 51
$275
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.