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 $457.09 Median $1,288.25 Typical High $4,265.80 | Facility | None | $457.09 | $1,288.25 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $549.54 | Professional | None | $263.03 | $354.81 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $2,570.40 | Professional | None | $257.04 | $281.84 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $724.44 | Professional | None | $275.42 | $416.87 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,047.13 | Professional | None | $489.78 | $630.96 | $1,047.13 |
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 $239.88 Median $389.05 Typical High $831.76 | Professional | None | $239.88 | $389.05 | $831.76 |
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 $131.83 Median $134.90 Typical High $229.09 | Professional | 52 · Reduced service | $131.83 | $134.90 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $91.20 | Professional | 53 · Discontinued | $52.48 | $53.70 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $204.17 Typical High $338.84 | Professional | 54 · Surgery only | $199.53 | $204.17 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $40.74 Typical High $69.18 | Professional | 55 · Aftercare only | $39.81 | $40.74 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.92 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.30 | $26.92 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $190.55 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $186.21 | $190.55 | $316.23 |
Where Washington, DC sits
The same service costs 4.1 times more in Alaska 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· 42nd of 51
$380
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.