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 $162.18 Median $1,698.24 Typical High $4,073.80 | Facility | None | $162.18 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $288.40 | Professional | None | $154.88 | $204.17 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $177.83 | Professional | None | $138.04 | $154.88 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $380.19 | Professional | None | $141.25 | $234.42 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $562.34 | Professional | None | $263.03 | $295.12 | $562.34 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $398.11 | Professional | None | $117.49 | $194.98 | $398.11 |
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 $77.62 Median $102.33 Typical High $144.54 | Professional | 52 · Reduced service | $77.62 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $58.88 | Professional | 53 · Discontinued | $30.90 | $40.74 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $218.78 | Professional | 54 · Surgery only | $117.49 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.20 Typical High $43.65 | Professional | 55 · Aftercare only | $23.44 | $30.20 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $204.17 |
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
$162
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.