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 $190.55 Median $1,698.24 Typical High $5,248.07 | Facility | None | $190.55 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $707.95 | Professional | None | $190.55 | $281.84 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $3,715.35 | Professional | None | $186.21 | $204.17 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $562.34 | Professional | None | $186.21 | $269.15 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $645.65 | Professional | None | $281.84 | $295.12 | $645.65 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $676.08 | Professional | None | $173.78 | $323.59 | $676.08 |
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 $95.50 Median $104.71 Typical High $141.25 | Professional | 52 · Reduced service | $95.50 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $41.69 Typical High $56.23 | Professional | 53 · Discontinued | $38.02 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $208.93 | Professional | 54 · Surgery only | $141.25 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.05 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $194.98 |
Where Washington, DC sits
The same service costs 4.0 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· 34th of 51
$282
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.