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 $2,818.38 Typical High $4,786.30 | Facility | None | $338.84 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $457.09 | Professional | None | $338.84 | $346.74 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $4,073.80 | Professional | None | $269.15 | $302.00 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $1,023.29 | Professional | None | $302.00 | $436.52 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $870.96 | Professional | None | $416.87 | $436.52 | $870.96 |
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 $281.84 Median $501.19 Typical High $1,047.13 | Professional | None | $281.84 | $501.19 | $1,047.13 |
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 $169.82 Median $173.78 Typical High $223.87 | Professional | 52 · Reduced service | $169.82 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $69.18 Typical High $91.20 | Professional | 53 · Discontinued | $67.61 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $338.84 | Professional | 54 · Surgery only | $251.19 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $239.88 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $234.42 | $239.88 | $316.23 |
Where Washington, DC sits
The same service costs 4.9 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· 37th 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.