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 $398.11 Median $1,096.48 Typical High $3,311.31 | Facility | None | $398.11 | $1,096.48 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $977.24 | Professional | None | $269.15 | $398.11 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $2,344.23 | Professional | None | $257.04 | $281.84 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $1,096.48 | Professional | None | $251.19 | $380.19 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $912.01 | Professional | None | $426.58 | $630.96 | $912.01 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $229.09 Median $446.68 Typical High $977.24 | Professional | None | $229.09 | $446.68 | $977.24 |
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 $134.90 Median $162.18 Typical High $199.53 | Professional | 52 · Reduced service | $134.90 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $53.70 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $245.47 Typical High $302.00 | Professional | 54 · Surgery only | $199.53 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $60.26 | Professional | 55 · Aftercare only | $40.74 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $229.09 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $186.21 | $229.09 | $281.84 |
Where Washington, DC sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 32nd of 51
$380
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.