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 $223.87 Median $1,412.54 Typical High $7,943.28 | Facility | None | $223.87 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $389.05 | Professional | None | $199.53 | $223.87 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $208.93 | Professional | None | $162.18 | $181.97 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $501.19 | Professional | None | $169.82 | $263.03 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $741.31 | Professional | None | $354.81 | $398.11 | $741.31 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $537.03 | Professional | None | $109.65 | $218.78 | $537.03 |
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 $112.20 Typical High $194.98 | Professional | 52 · Reduced service | $102.33 | $112.20 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $77.62 | Professional | 53 · Discontinued | $40.74 | $44.67 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $165.96 Typical High $288.40 | Professional | 54 · Surgery only | $154.88 | $165.96 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $58.88 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $154.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $144.54 | $154.88 | $269.15 |
Where Washington, DC sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 41st of 51
$224
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.