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 $199.53 Median $1,548.82 Typical High $3,311.31 | Facility | None | $199.53 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $263.03 | Professional | None | $199.53 | $204.17 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $2,089.30 | Professional | None | $173.78 | $190.55 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $645.65 | Professional | None | $186.21 | $239.88 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $524.81 | Professional | None | $239.88 | $251.19 | $524.81 |
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 $162.18 Median $288.40 Typical High $630.96 | Professional | None | $162.18 | $288.40 | $630.96 |
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 $100.00 Median $102.33 Typical High $131.83 | Professional | 52 · Reduced service | $100.00 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $40.74 Typical High $52.48 | Professional | 53 · Discontinued | $39.81 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $154.88 Typical High $199.53 | Professional | 54 · Surgery only | $151.36 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.90 Typical High $39.81 | Professional | 55 · Aftercare only | $30.20 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.95 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $144.54 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $141.25 | $144.54 | $186.21 |
Where Washington, DC sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 32nd of 51
$263
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.