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 $281.84 Median $2,818.38 Typical High $4,786.30 | Facility | None | $281.84 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $707.95 | Professional | None | $281.84 | $389.05 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $2,089.30 | Professional | None | $269.15 | $295.12 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $758.58 | Professional | None | $269.15 | $371.54 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $933.25 | Professional | None | $416.87 | $660.69 | $933.25 |
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 $239.88 Median $380.19 Typical High $870.96 | Professional | None | $239.88 | $380.19 | $870.96 |
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 $138.04 Median $141.25 Typical High $199.53 | Professional | 52 · Reduced service | $138.04 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $79.43 | Professional | 53 · Discontinued | $56.23 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $213.80 Typical High $302.00 | Professional | 54 · Surgery only | $208.93 | $213.80 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $60.26 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $199.53 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $194.98 | $199.53 | $281.84 |
Where Washington, DC sits
The same service costs 3.9 times more in Alaska 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· 40th of 51
$372
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.