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 $501.19 Median $2,818.38 Typical High $4,786.30 | Facility | None | $501.19 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $812.83 | Professional | None | $467.74 | $630.96 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $537.03 Typical High $12,302.69 | Professional | None | $245.47 | $537.03 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $724.44 Typical High $2,089.30 | Professional | None | $346.74 | $724.44 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,819.70 | Professional | None | $851.14 | $1,122.02 | $1,819.70 |
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 $309.03 Median $794.33 Typical High $1,949.84 | Professional | None | $309.03 | $794.33 | $1,949.84 |
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 $234.42 Median $316.23 Typical High $407.38 | Professional | 52 · Reduced service | $234.42 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $125.89 Typical High $165.96 | Professional | 53 · Discontinued | $93.33 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $467.74 Typical High $616.60 | Professional | 54 · Surgery only | $346.74 | $467.74 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $93.33 Typical High $123.03 | Professional | 55 · Aftercare only | $69.18 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $63.10 Typical High $81.28 | Professional | 56 · Pre-op care only | $46.77 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $436.52 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $323.59 | $436.52 | $575.44 |
Where Washington, DC sits
The same service costs 5.9 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· 28th of 51
$692
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.