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 $371.54 Median $3,548.13 Typical High $4,786.30 | Facility | None | $371.54 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $371.54 | Professional | None | $346.74 | $371.54 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $2,089.30 | Professional | None | $309.03 | $389.05 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $1,047.13 | Professional | None | $331.13 | $371.54 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $724.44 Typical High $851.14 | Professional | None | $363.08 | $724.44 | $851.14 |
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 $269.15 Median $501.19 Typical High $1,047.13 | Professional | None | $269.15 | $501.19 | $1,047.13 |
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 $173.78 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $69.18 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $34.67 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $239.88 | $263.03 | $263.03 |
Where Washington, DC sits
The same service costs 7.4 times more in Alaska than in Texas. 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· 40th of 51
$389
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.