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 $398.11 Median $1,698.24 Typical High $5,248.07 | Facility | None | $398.11 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $1,412.54 | Professional | None | $389.05 | $562.34 | $1,412.54 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $2,630.27 | Professional | None | $407.38 | $457.09 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $1,548.82 | Professional | None | $346.74 | $537.03 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,288.25 | Professional | None | $588.84 | $912.01 | $1,288.25 |
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 $295.12 Median $512.86 Typical High $1,258.93 | Professional | None | $295.12 | $512.86 | $1,258.93 |
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 $194.98 Median $239.88 Typical High $281.84 | Professional | 52 · Reduced service | $194.98 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $95.50 Typical High $112.20 | Professional | 53 · Discontinued | $79.43 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $354.81 Typical High $426.58 | Professional | 54 · Surgery only | $295.12 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $58.88 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $47.86 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.90 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $331.13 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $275.42 | $331.13 | $398.11 |
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
$550
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.