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 $1,698.24 Typical High $5,248.07 | Facility | None | $457.09 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $1,584.89 | Professional | None | $457.09 | $645.65 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $2,630.27 | Professional | None | $436.52 | $489.78 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $1,230.27 | Professional | None | $467.74 | $602.56 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,513.56 | Professional | None | $741.31 | $1,071.52 | $1,513.56 |
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 $363.08 Median $602.56 Typical High $1,258.93 | Professional | None | $363.08 | $602.56 | $1,258.93 |
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 $229.09 Median $229.09 Typical High $331.13 | Professional | 52 · Reduced service | $229.09 | $229.09 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $131.83 | Professional | 53 · Discontinued | $91.20 | $91.20 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $346.74 Typical High $489.78 | Professional | 54 · Surgery only | $338.84 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $69.18 Typical High $97.72 | Professional | 55 · Aftercare only | $67.61 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $323.59 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $316.23 | $323.59 | $457.09 |
Where Washington, DC sits
The same service costs 4.2 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· 34th of 51
$617
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.