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 $102.33 Median $1,412.54 Typical High $7,943.28 | Facility | None | $102.33 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $338.84 | Professional | None | $102.33 | $138.04 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $645.65 | Professional | None | $93.33 | $102.33 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $338.84 | Professional | None | $95.50 | $125.89 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $138.04 Typical High $275.42 | Professional | None | $131.83 | $138.04 | $275.42 |
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 $79.43 Median $147.91 Typical High $331.13 | Professional | None | $79.43 | $147.91 | $331.13 |
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 $48.98 Median $51.29 Typical High $69.18 | Professional | 52 · Reduced service | $48.98 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.42 Typical High $27.54 | Professional | 53 · Discontinued | $19.95 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $75.86 Typical High $104.71 | Professional | 54 · Surgery only | $74.13 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.14 Typical High $20.89 | Professional | 55 · Aftercare only | $14.79 | $15.14 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.23 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.77 | $10.23 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $70.79 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $69.18 | $70.79 | $97.72 |
Where Washington, DC sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 30th of 51
$132
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.