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 $2,818.38 Typical High $4,786.30 | Facility | None | $190.55 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $309.03 | Professional | None | $151.36 | $190.55 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $2,089.30 | Professional | None | $147.91 | $162.18 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $602.56 | Professional | None | $138.04 | $223.87 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $575.44 | Professional | None | $257.04 | $346.74 | $575.44 |
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 $114.82 Median $208.93 Typical High $602.56 | Professional | None | $114.82 | $208.93 | $602.56 |
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 $89.13 Median $93.33 Typical High $154.88 | Professional | 52 · Reduced service | $89.13 | $93.33 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $61.66 | Professional | 53 · Discontinued | $35.48 | $38.02 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $141.25 Typical High $234.42 | Professional | 54 · Surgery only | $131.83 | $141.25 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.18 Typical High $46.77 | Professional | 55 · Aftercare only | $26.30 | $28.18 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $131.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $123.03 | $131.83 | $218.78 |
Where Washington, DC sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 43rd of 51
$204
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.