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 $389.05 Median $2,818.38 Typical High $4,786.30 | Facility | None | $389.05 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $549.54 | Professional | None | $389.05 | $416.87 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $398.11 | Professional | None | $309.03 | $346.74 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $707.95 | Professional | None | $331.13 | $446.68 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $977.24 | Professional | None | $457.09 | $512.86 | $977.24 |
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 $416.87 Typical High $933.25 | Professional | None | $281.84 | $416.87 | $933.25 |
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 $194.98 Median $208.93 Typical High $275.42 | Professional | 52 · Reduced service | $194.98 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $77.62 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $288.40 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $81.28 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $288.40 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $269.15 | $288.40 | $380.19 |
Where Washington, DC sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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
$389
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.