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 $436.52 Median $1,548.82 Typical High $3,311.31 | Facility | None | $436.52 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $1,047.13 | Professional | None | $398.11 | $446.68 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $1,380.38 | Professional | None | $371.54 | $467.74 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $1,288.25 | Professional | None | $371.54 | $457.09 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $1,000.00 Typical High $1,096.48 | Professional | None | $524.81 | $1,000.00 | $1,096.48 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $323.59 Median $588.84 Typical High $1,202.26 | Professional | None | $323.59 | $588.84 | $1,202.26 |
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 $204.17 Median $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $81.28 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $331.13 |
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· 34th of 51
$479
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.