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 $407.38 Median $2,818.38 Typical High $4,786.30 | Facility | None | $407.38 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | None | $257.04 | $407.38 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $467.74 | Professional | None | $363.08 | $407.38 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $575.44 | Professional | None | $257.04 | $371.54 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $794.33 | Professional | None | $338.84 | $380.19 | $794.33 |
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 $169.82 Median $316.23 Typical High $691.83 | Professional | None | $169.82 | $316.23 | $691.83 |
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 $131.83 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $131.83 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $52.48 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $194.98 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $39.81 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $26.30 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $181.97 | $288.40 | $288.40 |
Where Washington, DC sits
The same service costs 4.6 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· 27th of 51
$372
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.