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 $501.19 Median $4,897.79 Typical High $13,803.84 | Facility | None | $501.19 | $4,897.79 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $5,623.41 Typical High $7,585.78 | Professional | None | $501.19 | $5,623.41 | $7,585.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $2,511.89 Typical High $3,801.89 | Professional | 52 · Reduced service | $251.19 | $2,511.89 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $1,023.29 Typical High $1,513.56 | Professional | 53 · Discontinued | $100.00 | $1,023.29 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $758.58 Typical High $1,122.02 | Professional | 55 · Aftercare only | $75.86 | $758.58 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $512.86 Typical High $758.58 | Professional | 56 · Pre-op care only | $50.12 | $512.86 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $3,548.13 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $354.81 | $3,548.13 | $5,248.07 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $524.81 | Professional | None | $407.38 | $457.09 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,174.90 Typical High $9,549.93 | Professional | None | $446.68 | $1,174.90 | $9,549.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,754.40 Median $6,456.54 Typical High $14,125.38 | Professional | None | $5,754.40 | $6,456.54 | $14,125.38 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $407.38 Median $4,466.84 Typical High $11,481.54 | Professional | None | $407.38 | $4,466.84 | $11,481.54 |
1 more rate 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 54 · Surgery only Typical Low $380.19 Median $3,801.89 Typical High $5,623.41 | Professional | 54 · Surgery only | $380.19 | $3,801.89 | $5,623.41 |
Where Washington, DC sits
The same service costs 17.8 times more in Iowa 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
$525
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.