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 $102.33 Median $245.47 Typical High $4,073.80 | Facility | None | $102.33 | $245.47 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $194.98 | Professional | None | $87.10 | $114.82 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $645.65 | Professional | None | $79.43 | $87.10 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $263.03 | Professional | None | $74.13 | $107.15 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $234.42 | Professional | None | $102.33 | $190.55 | $234.42 |
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 $75.86 Median $100.00 Typical High $245.47 | Professional | None | $75.86 | $100.00 | $245.47 |
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 $46.77 Median $51.29 Typical High $63.10 | Professional | 52 · Reduced service | $46.77 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $20.42 Typical High $25.12 | Professional | 53 · Discontinued | $19.05 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $70.79 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.14 Typical High $19.05 | Professional | 55 · Aftercare only | $14.13 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.23 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.33 | $10.23 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $70.79 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $66.07 | $70.79 | $87.10 |
Where Washington, DC sits
The same service costs 4.2 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· 39th of 51
$102
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.