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 $295.12 Median $2,818.38 Typical High $4,786.30 | Facility | None | $295.12 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $891.25 | Professional | None | $288.40 | $426.58 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $2,344.23 | Professional | None | $281.84 | $316.23 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $1,230.27 | Professional | None | $269.15 | $436.52 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,047.13 | Professional | None | $467.74 | $676.08 | $1,047.13 |
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 $269.15 Median $501.19 Typical High $1,122.02 | Professional | None | $269.15 | $501.19 | $1,122.02 |
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 $147.91 Median $194.98 Typical High $229.09 | Professional | 52 · Reduced service | $147.91 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $77.62 Typical High $91.20 | Professional | 53 · Discontinued | $58.88 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $288.40 Typical High $338.84 | Professional | 54 · Surgery only | $218.78 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $57.54 Typical High $69.18 | Professional | 55 · Aftercare only | $43.65 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $38.90 Typical High $45.71 | Professional | 56 · Pre-op care only | $29.51 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $269.15 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $204.17 | $269.15 | $316.23 |
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· 29th of 51
$437
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.