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 $288.40 Median $1,698.24 Typical High $5,248.07 | Facility | None | $288.40 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $323.59 | Professional | None | $281.84 | $309.03 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $1,584.89 | Professional | None | $281.84 | $309.03 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $891.25 | Professional | None | $275.42 | $316.23 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $660.69 Typical High $758.58 | Professional | None | $338.84 | $660.69 | $758.58 |
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 $251.19 Median $426.58 Typical High $812.83 | Professional | None | $251.19 | $426.58 | $812.83 |
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 $141.25 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $213.80 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $46.77 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $199.53 | $213.80 | $229.09 |
Where Washington, DC sits
The same service costs 6.8 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· 35th of 51
$324
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.