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 $316.23 Median $1,698.24 Typical High $4,786.30 | Facility | None | $316.23 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $933.25 | Professional | None | $316.23 | $467.74 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $2,089.30 | Professional | None | $309.03 | $346.74 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $1,318.26 | Professional | None | $295.12 | $457.09 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,096.48 | Professional | None | $489.78 | $741.31 | $1,096.48 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $288.40 Median $537.03 Typical High $1,174.90 | Professional | None | $288.40 | $537.03 | $1,174.90 |
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 $158.49 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $158.49 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $63.10 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $239.88 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $31.62 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $338.84 |
Where Washington, DC sits
The same service costs 4.9 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· 31st 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.