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 $263.03 Median $1,412.54 Typical High $7,943.28 | Facility | None | $263.03 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $660.69 | Professional | None | $251.19 | $467.74 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $2,630.27 | Professional | None | $208.93 | $288.40 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $524.81 Typical High $1,737.80 | Professional | None | $234.42 | $524.81 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,479.11 | Professional | None | $602.56 | $758.58 | $1,479.11 |
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 $223.87 Median $512.86 Typical High $1,621.81 | Professional | None | $223.87 | $512.86 | $1,621.81 |
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 $128.82 Median $234.42 Typical High $331.13 | Professional | 52 · Reduced service | $128.82 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $95.50 Typical High $131.83 | Professional | 53 · Discontinued | $51.29 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $354.81 Typical High $489.78 | Professional | 54 · Surgery only | $194.98 | $354.81 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $70.79 Typical High $100.00 | Professional | 55 · Aftercare only | $38.90 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $46.77 Typical High $66.07 | Professional | 56 · Pre-op care only | $25.70 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $331.13 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $181.97 | $331.13 | $457.09 |
Where Washington, DC sits
The same service costs 3.7 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· 40th of 51
$468
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.