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 $257.04 Median $1,698.24 Typical High $5,248.07 | Facility | None | $257.04 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $1,202.26 | Professional | None | $257.04 | $501.19 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $2,344.23 | Professional | None | $245.47 | $275.42 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $1,348.96 | Professional | None | $234.42 | $467.74 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $1,122.02 | Professional | None | $537.03 | $588.84 | $1,122.02 |
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 $218.78 Median $489.78 Typical High $1,230.27 | Professional | None | $218.78 | $489.78 | $1,230.27 |
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 $125.89 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $125.89 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $50.12 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $190.55 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $38.02 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $25.12 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $177.83 | $295.12 | $354.81 |
Where Washington, DC sits
The same service costs 3.2 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· 30th 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.