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 $331.13 Median $1,548.82 Typical High $3,311.31 | Facility | None | $331.13 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $794.33 | Professional | None | $309.03 | $331.13 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $741.31 | Professional | None | $323.59 | $354.81 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $933.25 | Professional | None | $288.40 | $331.13 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $794.33 | Professional | None | $389.05 | $758.58 | $794.33 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $912.01 | Professional | None | $234.42 | $426.58 | $912.01 |
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 $151.36 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $151.36 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $69.18 | Professional | 53 · Discontinued | $60.26 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $251.19 Typical High $257.04 | Professional | 54 · Surgery only | $229.09 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $51.29 | Professional | 55 · Aftercare only | $45.71 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $234.42 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $213.80 | $234.42 | $239.88 |
Where Washington, DC sits
The same service costs 5.5 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
$355
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.