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 $257.04 Median $2,818.38 Typical High $4,786.30 | Facility | None | $257.04 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $794.33 | Professional | None | $257.04 | $398.11 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $2,344.23 | Professional | None | $251.19 | $275.42 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $1,096.48 | Professional | None | $239.88 | $380.19 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $912.01 | Professional | None | $407.38 | $588.84 | $912.01 |
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 $446.68 Typical High $1,000.00 | Professional | None | $234.42 | $446.68 | $1,000.00 |
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 $128.82 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $128.82 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $51.29 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $194.98 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $38.90 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $181.97 | $239.88 | $281.84 |
Where Washington, DC sits
The same service costs 4.3 times more in Alaska than in Texas. 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
$389
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.