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 $416.87 Median $1,071.52 Typical High $5,248.07 | Facility | None | $416.87 | $1,071.52 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $691.83 | Professional | None | $251.19 | $407.38 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $1,584.89 | Professional | None | $208.93 | $229.09 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $660.69 | Professional | None | $257.04 | $398.11 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $954.99 | Professional | None | $416.87 | $575.44 | $954.99 |
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 $234.42 Median $389.05 Typical High $870.96 | Professional | None | $234.42 | $389.05 | $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 $123.03 Median $125.89 Typical High $208.93 | Professional | 52 · Reduced service | $123.03 | $125.89 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $83.18 | Professional | 53 · Discontinued | $48.98 | $50.12 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $309.03 | Professional | 54 · Surgery only | $181.97 | $186.21 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $63.10 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $41.69 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $173.78 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $169.82 | $173.78 | $288.40 |
Where Washington, DC sits
The same service costs 3.3 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· 28th of 51
$389
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.