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 $281.84 Median $2,818.38 Typical High $4,786.30 | Facility | None | $281.84 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $851.14 | Professional | None | $281.84 | $436.52 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $2,089.30 | Professional | None | $275.42 | $302.00 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $1,174.90 | Professional | None | $251.19 | $416.87 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,000.00 | Professional | None | $446.68 | $645.65 | $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 $239.88 Median $478.63 Typical High $1,071.52 | Professional | None | $239.88 | $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 $141.25 Median $181.97 Typical High $218.78 | Professional | 52 · Reduced service | $141.25 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $56.23 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $208.93 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $41.69 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.18 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $194.98 | $257.04 | $302.00 |
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· 30th 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.