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 $3,388.44 Typical High $6,606.93 | Facility | None | $436.52 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $501.19 | Professional | None | $416.87 | $436.52 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $5,011.87 | Professional | None | $416.87 | $467.74 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $1,202.26 | Professional | None | $407.38 | $426.58 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $870.96 Typical High $1,000.00 | Professional | None | $416.87 | $870.96 | $1,000.00 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $1,202.26 | Professional | None | $371.54 | $616.60 | $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 $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $204.17 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $100.00 | Professional | 53 · Discontinued | $83.18 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $309.03 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $346.74 |
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· 41st of 51
$468
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.