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 $263.03 Median $1,698.24 Typical High $5,248.07 | Facility | None | $263.03 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $891.25 | Professional | None | $263.03 | $398.11 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $3,235.94 | Professional | None | $245.47 | $275.42 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $660.69 Typical High $1,047.13 | Professional | None | $245.47 | $660.69 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,445.44 | Professional | None | $398.11 | $588.84 | $1,445.44 |
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 $501.19 Median $724.44 Typical High $1,202.26 | Professional | None | $501.19 | $724.44 | $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 $131.83 Median $199.53 Typical High $309.03 | Professional | 52 · Reduced service | $131.83 | $199.53 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $79.43 Typical High $125.89 | Professional | 53 · Discontinued | $52.48 | $79.43 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $295.12 Typical High $467.74 | Professional | 54 · Surgery only | $194.98 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $58.88 Typical High $93.33 | Professional | 55 · Aftercare only | $38.90 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $39.81 Typical High $61.66 | Professional | 56 · Pre-op care only | $26.30 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $275.42 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $181.97 | $275.42 | $436.52 |
Where Washington, DC sits
The same service costs 4.0 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· 27th of 51
$603
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.