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 $186.21 Median $3,090.30 Typical High $6,606.93 | Facility | None | $186.21 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $354.81 | Professional | None | $181.97 | $257.04 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $194.98 | Professional | None | $147.91 | $165.96 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $426.58 | Professional | None | $162.18 | $263.03 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $676.08 | Professional | None | $309.03 | $338.84 | $676.08 |
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 $131.83 Median $213.80 Typical High $457.09 | Professional | None | $131.83 | $213.80 | $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 $89.13 Median $102.33 Typical High $177.83 | Professional | 52 · Reduced service | $89.13 | $102.33 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $70.79 | Professional | 53 · Discontinued | $36.31 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $154.88 Typical High $263.03 | Professional | 54 · Surgery only | $134.90 | $154.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.90 Typical High $52.48 | Professional | 55 · Aftercare only | $26.92 | $30.90 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.89 Typical High $35.48 | Professional | 56 · Pre-op care only | $17.78 | $20.89 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $144.54 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $125.89 | $144.54 | $245.47 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 51st of 51
$186
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.