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 $363.08 Median $1,584.89 Typical High $4,073.80 | Facility | None | $363.08 | $1,584.89 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $363.08 | Professional | None | $316.23 | $363.08 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $371.54 | Professional | None | $288.40 | $323.59 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $575.44 | Professional | None | $275.42 | $323.59 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $707.95 | Professional | None | $288.40 | $323.59 | $707.95 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $794.33 | Professional | None | $223.87 | $288.40 | $794.33 |
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 $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $251.19 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $234.42 | $251.19 | $251.19 |
Where Washington, DC sits
The same service costs 4.8 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· 38th of 51
$324
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.