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 $338.84 Median $1,698.24 Typical High $5,248.07 | Facility | None | $338.84 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $1,122.02 | Professional | None | $338.84 | $549.54 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $2,818.38 | Professional | None | $245.47 | $295.12 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $707.95 Typical High $1,122.02 | Professional | None | $275.42 | $707.95 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $1,318.26 | Professional | None | $616.60 | $977.24 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $316.23 Median $741.31 Typical High $1,348.96 | Professional | None | $316.23 | $741.31 | $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 $165.96 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $165.96 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $67.61 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $346.74 Typical High $416.87 | Professional | 54 · Surgery only | $251.19 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $50.12 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.88 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $323.59 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $234.42 | $323.59 | $389.05 |
Where Washington, DC sits
The same service costs 4.1 times more in Wisconsin 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· 22nd of 51
$646
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.