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 $3,548.13 Typical High $4,786.30 | Facility | None | $346.74 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $346.74 | Professional | None | $295.12 | $346.74 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $2,570.40 | Professional | None | $281.84 | $371.54 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $954.99 | Professional | None | $295.12 | $338.84 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $660.69 Typical High $794.33 | Professional | None | $331.13 | $660.69 | $794.33 |
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 $234.42 Median $436.52 Typical High $954.99 | Professional | None | $234.42 | $436.52 | $954.99 |
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 $147.91 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $147.91 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $60.26 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $257.04 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $29.51 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $239.88 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $239.88 | $245.47 |
Where Washington, DC sits
The same service costs 6.2 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· 36th of 51
$372
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.