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 $114.82 Median $1,698.24 Typical High $4,073.80 | Facility | None | $114.82 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $426.58 | Professional | None | $114.82 | $169.82 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $2,089.30 | Professional | None | $107.15 | $147.91 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $524.81 | Professional | None | $125.89 | $181.97 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $457.09 | Professional | None | $199.53 | $208.93 | $457.09 |
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 $120.23 Median $218.78 Typical High $489.78 | Professional | None | $120.23 | $218.78 | $489.78 |
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 $57.54 Median $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $57.54 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.30 Typical High $33.88 | Professional | 53 · Discontinued | $22.91 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $87.10 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $17.38 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.18 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.48 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $91.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $81.28 | $91.20 | $117.49 |
Where Washington, DC sits
The same service costs 3.9 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· 43rd of 51
$170
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.