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 $177.83 Median $2,818.38 Typical High $4,786.30 | Facility | None | $177.83 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $380.19 | Professional | None | $169.82 | $177.83 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $2,570.40 | Professional | None | $128.82 | $144.54 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $630.96 | Professional | None | $128.82 | $245.47 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $660.69 | Professional | None | $309.03 | $354.81 | $660.69 |
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 $107.15 Median $239.88 Typical High $724.44 | Professional | None | $107.15 | $239.88 | $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 $85.11 Median $89.13 Typical High $190.55 | Professional | 52 · Reduced service | $85.11 | $89.13 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $75.86 | Professional | 53 · Discontinued | $33.88 | $35.48 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $134.90 Typical High $281.84 | Professional | 54 · Surgery only | $125.89 | $134.90 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.92 Typical High $56.23 | Professional | 55 · Aftercare only | $25.12 | $26.92 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $38.02 | Professional | 56 · Pre-op care only | $16.98 | $17.78 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $125.89 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $117.49 | $125.89 | $263.03 |
Where Washington, DC sits
The same service costs 6.0 times more in Alaska than in Virginia. 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· 47th of 51
$219
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.