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 $380.19 Median $1,698.24 Typical High $5,248.07 | Facility | None | $380.19 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $1,412.54 | Professional | None | $363.08 | $588.84 | $1,412.54 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $741.31 | Professional | None | $309.03 | $338.84 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $891.25 | Professional | None | $331.13 | $467.74 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,148.15 | Professional | None | $616.60 | $707.95 | $1,148.15 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $1,000.00 | Professional | None | $295.12 | $446.68 | $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 $177.83 Median $186.21 Typical High $295.12 | Professional | 52 · Reduced service | $177.83 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $75.86 Typical High $117.49 | Professional | 53 · Discontinued | $72.44 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $436.52 | Professional | 54 · Surgery only | $269.15 | $281.84 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $89.13 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $58.88 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $263.03 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $251.19 | $263.03 | $407.38 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 43rd 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.