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 $162.18 Median $426.58 Typical High $3,311.31 | Facility | None | $162.18 | $426.58 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $398.11 | Professional | None | $125.89 | $162.18 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $741.31 | Professional | None | $123.03 | $138.04 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $416.87 | Professional | None | $114.82 | $144.54 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $363.08 | Professional | None | $165.96 | $288.40 | $363.08 |
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 $117.49 Median $204.17 Typical High $389.05 | Professional | None | $117.49 | $204.17 | $389.05 |
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 $63.10 Median $70.79 Typical High $81.28 | Professional | 52 · Reduced service | $63.10 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.18 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $95.50 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.13 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $97.72 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $89.13 | $97.72 | $112.20 |
Where Washington, DC sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 37th of 51
$162
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.