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 $346.74 Median $2,137.96 Typical High $6,606.93 | Facility | None | $346.74 | $2,137.96 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | None | $302.00 | $346.74 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $371.54 | Professional | None | $275.42 | $309.03 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $549.54 | Professional | None | $281.84 | $309.03 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $588.84 | Professional | None | $245.47 | $275.42 | $588.84 |
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 $229.09 Median $269.15 Typical High $758.58 | Professional | None | $229.09 | $269.15 | $758.58 |
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 $162.18 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $229.09 | $239.88 | $239.88 |
Where Washington, DC sits
The same service costs 5.5 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· 39th of 51
$309
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.