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 $363.08 Median $1,548.82 Typical High $3,311.31 | Facility | None | $363.08 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $1,122.02 | Professional | None | $346.74 | $457.09 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $2,089.30 | Professional | None | $346.74 | $389.05 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $1,258.93 | Professional | None | $316.23 | $436.52 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,047.13 | Professional | None | $501.19 | $831.76 | $1,047.13 |
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 $302.00 Median $562.34 Typical High $1,122.02 | Professional | None | $302.00 | $562.34 | $1,122.02 |
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 $173.78 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $173.78 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $69.18 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $263.03 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $323.59 |
Where Washington, DC sits
The same service costs 4.9 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· 34th of 51
$457
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.