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 $275.42 Median $1,698.24 Typical High $4,073.80 | Facility | None | $275.42 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $870.96 | Professional | None | $275.42 | $436.52 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $2,570.40 | Professional | None | $269.15 | $295.12 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $1,202.26 | Professional | None | $245.47 | $416.87 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,000.00 | Professional | None | $446.68 | $630.96 | $1,000.00 |
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 $234.42 Median $478.63 Typical High $1,071.52 | Professional | None | $234.42 | $478.63 | $1,071.52 |
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 $138.04 Median $186.21 Typical High $218.78 | Professional | 52 · Reduced service | $138.04 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $54.95 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $204.17 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $40.74 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $27.54 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $263.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $190.55 | $263.03 | $309.03 |
Where Washington, DC sits
The same service costs 5.2 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· 29th of 51
$417
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.