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 $346.74 Median $1,698.24 Typical High $4,786.30 | Facility | None | $346.74 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $851.14 | Professional | None | $338.84 | $478.63 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $2,344.23 | Professional | None | $338.84 | $371.54 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $1,348.96 | Professional | None | $309.03 | $478.63 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,148.15 | Professional | None | $512.86 | $794.33 | $1,148.15 |
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 $173.78 Median $213.80 Typical High $251.19 | Professional | 52 · Reduced service | $173.78 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $69.18 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $257.04 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $51.29 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $34.67 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $239.88 | $295.12 | $346.74 |
Where Washington, DC sits
The same service costs 4.7 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· 34th of 51
$479
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.