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 $3,090.30 Typical High $6,606.93 | Facility | None | $331.13 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $1,000.00 | Professional | None | $331.13 | $501.19 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $2,630.27 | Professional | None | $316.23 | $346.74 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $1,348.96 | Professional | None | $316.23 | $478.63 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,122.02 | Professional | None | $512.86 | $758.58 | $1,122.02 |
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 $302.00 Median $562.34 Typical High $1,230.27 | Professional | None | $302.00 | $562.34 | $1,230.27 |
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 $165.96 Median $218.78 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $87.10 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $346.74 |
Where Washington, DC sits
The same service costs 5.4 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· 32nd of 51
$490
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.