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 $1,698.24 Typical High $4,786.30 | Facility | None | $281.84 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $1,122.02 | Professional | None | $281.84 | $436.52 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $1,584.89 | Professional | None | $223.87 | $245.47 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $758.58 | Professional | None | $288.40 | $416.87 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,047.13 | Professional | None | $512.86 | $660.69 | $1,047.13 |
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 $257.04 Median $416.87 Typical High $933.25 | Professional | None | $257.04 | $416.87 | $933.25 |
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 $141.25 Median $141.25 Typical High $223.87 | Professional | 52 · Reduced service | $141.25 | $141.25 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $89.13 | Professional | 53 · Discontinued | $56.23 | $56.23 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $213.80 Typical High $338.84 | Professional | 54 · Surgery only | $208.93 | $213.80 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $67.61 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $199.53 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $194.98 | $199.53 | $316.23 |
Where Washington, DC sits
The same service costs 3.3 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· 34th of 51
$417
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.