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 $457.09 Median $3,090.30 Typical High $6,606.93 | Facility | None | $457.09 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $1,148.15 Typical High $3,235.94 | Professional | None | $457.09 | $1,148.15 | $3,235.94 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $2,398.83 | Professional | None | $346.74 | $389.05 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,122.02 Typical High $2,884.03 | Professional | None | $371.54 | $1,122.02 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $2,570.40 Typical High $2,630.27 | Professional | None | $831.76 | $2,570.40 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $346.74 Median $1,122.02 Typical High $3,467.37 | Professional | None | $346.74 | $1,122.02 | $3,467.37 |
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 $229.09 Median $229.09 Typical High $758.58 | Professional | 52 · Reduced service | $229.09 | $229.09 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $302.00 | Professional | 53 · Discontinued | $91.20 | $91.20 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $1,148.15 | Professional | 54 · Surgery only | $346.74 | $346.74 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $229.09 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $151.36 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $1,071.52 |
Where Washington, DC sits
The same service costs 5.5 times more in Alaska than in Nebraska. 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· 42nd of 51
$1,175
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.