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 $3,090.30 Typical High $6,606.93 | Facility | None | $371.54 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $933.25 | Professional | None | $371.54 | $549.54 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $2,630.27 | Professional | None | $363.08 | $398.11 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $1,548.82 | Professional | None | $346.74 | $549.54 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,288.25 | Professional | None | $616.60 | $851.14 | $1,288.25 |
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 $331.13 Median $630.96 Typical High $1,412.54 | Professional | None | $331.13 | $630.96 | $1,412.54 |
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 $186.21 Median $245.47 Typical High $288.40 | Professional | 52 · Reduced service | $186.21 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $74.13 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $363.08 Typical High $426.58 | Professional | 54 · Surgery only | $281.84 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $56.23 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $37.15 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $338.84 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $263.03 | $338.84 | $398.11 |
Where Washington, DC sits
The same service costs 4.8 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· 31st of 51
$550
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.