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 $363.08 Median $2,818.38 Typical High $4,786.30 | Facility | None | $363.08 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $588.84 | Professional | None | $363.08 | $489.78 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $3,235.94 | Professional | None | $338.84 | $380.19 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $1,513.56 | Professional | None | $338.84 | $575.44 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,348.96 | Professional | None | $575.44 | $812.83 | $1,348.96 |
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 $331.13 Median $741.31 Typical High $1,380.38 | Professional | None | $331.13 | $741.31 | $1,380.38 |
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 $181.97 Median $245.47 Typical High $288.40 | Professional | 52 · Reduced service | $181.97 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $72.44 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $275.42 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $74.13 Typical High $87.10 | Professional | 55 · Aftercare only | $54.95 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $36.31 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $346.74 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $257.04 | $346.74 | $407.38 |
Where Washington, DC sits
The same service costs 5.2 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· 33rd of 51
$575
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.