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 $389.05 Median $2,818.38 Typical High $4,786.30 | Facility | None | $389.05 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $426.58 | Professional | None | $354.81 | $389.05 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $2,089.30 | Professional | None | $363.08 | $407.38 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $1,148.15 | Professional | None | $331.13 | $398.11 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $870.96 Typical High $954.99 | Professional | None | $478.63 | $870.96 | $954.99 |
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 $288.40 Median $512.86 Typical High $1,071.52 | Professional | None | $288.40 | $512.86 | $1,071.52 |
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 $177.83 Median $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $177.83 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $70.79 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $316.23 | Professional | 54 · Surgery only | $269.15 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $57.54 Typical High $63.10 | Professional | 55 · Aftercare only | $53.70 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $269.15 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $251.19 | $269.15 | $295.12 |
Where Washington, DC sits
The same service costs 5.4 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
$427
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.