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 $281.84 Median $1,584.89 Typical High $4,073.80 | Facility | None | $281.84 | $1,584.89 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $691.83 | Professional | None | $269.15 | $281.84 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $3,235.94 | Professional | None | $269.15 | $302.00 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $776.25 | Professional | None | $269.15 | $275.42 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $562.34 Typical High $630.96 | Professional | None | $269.15 | $562.34 | $630.96 |
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 $229.09 Median $407.38 Typical High $776.25 | Professional | None | $229.09 | $407.38 | $776.25 |
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 $131.83 Median $141.25 Typical High $151.36 | Professional | 52 · Reduced service | $131.83 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $56.23 Typical High $61.66 | Professional | 53 · Discontinued | $53.70 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $208.93 Typical High $229.09 | Professional | 54 · Surgery only | $199.53 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $39.81 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.92 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $194.98 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $186.21 | $194.98 | $213.80 |
Where Washington, DC sits
The same service costs 5.0 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· 39th of 51
$309
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.