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 $346.74 Median $3,090.30 Typical High $6,606.93 | Facility | None | $346.74 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $478.63 | Professional | None | $338.84 | $407.38 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $3,235.94 | Professional | None | $288.40 | $354.81 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $1,288.25 | Professional | None | $309.03 | $446.68 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $1,096.48 | Professional | None | $478.63 | $794.33 | $1,096.48 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $295.12 Median $537.03 Typical High $1,174.90 | Professional | None | $295.12 | $537.03 | $1,174.90 |
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 $169.82 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $169.82 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $67.61 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $251.19 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $72.44 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $234.42 | $281.84 | $338.84 |
Where Washington, DC sits
The same service costs 5.0 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· 35th of 51
$447
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.