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 $446.68 Median $1,698.24 Typical High $4,786.30 | Facility | None | $446.68 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $616.60 | Professional | None | $389.05 | $446.68 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $3,235.94 | Professional | None | $354.81 | $398.11 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $1,348.96 | Professional | None | $389.05 | $524.81 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $1,174.90 | Professional | None | $524.81 | $562.34 | $1,174.90 |
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 $331.13 Median $616.60 Typical High $1,348.96 | Professional | None | $331.13 | $616.60 | $1,348.96 |
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 $223.87 Typical High $309.03 | Professional | 52 · Reduced service | $194.98 | $223.87 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $89.13 Typical High $123.03 | Professional | 53 · Discontinued | $77.62 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $338.84 Typical High $467.74 | Professional | 54 · Surgery only | $288.40 | $338.84 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $93.33 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $44.67 Typical High $61.66 | Professional | 56 · Pre-op care only | $38.90 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $316.23 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $269.15 | $316.23 | $436.52 |
Where Washington, DC sits
The same service costs 5.4 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
$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.