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 $199.53 Median $1,698.24 Typical High $4,786.30 | Facility | None | $199.53 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $478.63 | Professional | None | $158.49 | $275.42 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $1,412.54 | Professional | None | $144.54 | $162.18 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $645.65 | Professional | None | $144.54 | $263.03 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $660.69 | Professional | None | $302.00 | $346.74 | $660.69 |
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 $251.19 Typical High $724.44 | Professional | None | $120.23 | $251.19 | $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 $93.33 Median $100.00 Typical High $186.21 | Professional | 52 · Reduced service | $93.33 | $100.00 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $39.81 Typical High $74.13 | Professional | 53 · Discontinued | $38.02 | $39.81 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $151.36 Typical High $275.42 | Professional | 54 · Surgery only | $141.25 | $151.36 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.20 Typical High $56.23 | Professional | 55 · Aftercare only | $28.18 | $30.20 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.95 Typical High $37.15 | Professional | 56 · Pre-op care only | $18.62 | $19.95 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $141.25 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $131.83 | $141.25 | $257.04 |
Where Washington, DC sits
The same service costs 3.8 times more in Wyoming 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· 41st of 51
$251
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.