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 $229.09 Median $2,818.38 Typical High $4,786.30 | Facility | None | $229.09 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | None | $229.09 | $229.09 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $2,137.96 | Professional | None | $177.83 | $199.53 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $389.05 Typical High $912.01 | Professional | None | $190.55 | $389.05 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $812.83 | Professional | None | $426.58 | $676.08 | $812.83 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $173.78 Median $501.19 Typical High $1,000.00 | Professional | None | $173.78 | $501.19 | $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 $114.82 Median $114.82 Typical High $229.09 | Professional | 52 · Reduced service | $114.82 | $114.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 53 · Discontinued | $45.71 | $45.71 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $338.84 | Professional | 54 · Surgery only | $173.78 | $173.78 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $69.18 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $316.23 |
Where Washington, DC sits
The same service costs 3.4 times more in Alaska than in New York. 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· 27th of 51
$437
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.