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 $181.97 Median $3,090.30 Typical High $6,606.93 | Facility | None | $181.97 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $602.56 | Professional | None | $181.97 | $239.88 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $2,951.21 | Professional | None | $208.93 | $234.42 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $741.31 | Professional | None | $199.53 | $275.42 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $645.65 | Professional | None | $295.12 | $309.03 | $645.65 |
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 $194.98 Median $338.84 Typical High $724.44 | Professional | None | $194.98 | $338.84 | $724.44 |
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 $91.20 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $91.20 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $44.67 Typical High $47.86 | Professional | 53 · Discontinued | $36.31 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $165.96 Typical High $177.83 | Professional | 54 · Surgery only | $134.90 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $26.92 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.20 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $125.89 | $154.88 | $169.82 |
Where Washington, DC sits
The same service costs 4.7 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· 46th 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.