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 $3,388.44 Typical High $6,606.93 | Facility | None | $389.05 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $977.24 | Professional | None | $338.84 | $389.05 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $2,630.27 | Professional | None | $371.54 | $416.87 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $1,071.52 | Professional | None | $331.13 | $380.19 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $724.44 Typical High $891.25 | Professional | None | $389.05 | $724.44 | $891.25 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $263.03 Median $501.19 Typical High $1,071.52 | Professional | None | $263.03 | $501.19 | $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 $169.82 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $239.88 | $269.15 | $269.15 |
Where Washington, DC sits
The same service costs 6.5 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
$417
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.