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 $239.88 Median $2,818.38 Typical High $4,786.30 | Facility | None | $239.88 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $389.05 | Professional | None | $239.88 | $331.13 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $2,570.40 | Professional | None | $234.42 | $257.04 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $1,047.13 | Professional | None | $223.87 | $363.08 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $870.96 | Professional | None | $389.05 | $549.54 | $870.96 |
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 $218.78 Median $426.58 Typical High $954.99 | Professional | None | $218.78 | $426.58 | $954.99 |
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 $120.23 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $120.23 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $66.07 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $245.47 Typical High $288.40 | Professional | 54 · Surgery only | $181.97 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $36.31 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.11 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $229.09 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $169.82 | $229.09 | $269.15 |
Where Washington, DC sits
The same service costs 5.5 times more in Alaska than in Texas. 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· 32nd of 51
$363
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.